Active NPI
Ketsia Dajuste
- Physician Assistant
- Winder, GA
National Provider Identifier
1477313419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13957
- Practice address
- 24 Amherst Dr
Winder, GA 30680-7463 - Phone
- (470) 900-4368
- NPI assigned
- Mar 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13957 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
24 Amherst Dr
Winder, GA 30680-7463
Mailing address
1496 Castleberry Dr
Buford, GA 30518-5069
Phone (678) 200-7938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1477313419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1496 CASTLEBERRY DR",
"city": "BUFORD",
"state": "GA",
"postal_code": "305185069",
"telephone_number": "678-200-7938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 AMHERST DR",
"city": "WINDER",
"state": "GA",
"postal_code": "306807463",
"telephone_number": "470-900-4368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAJUSTE",
"first_name": "KETSIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-19",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "13957",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winder, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.