Individual provider Active NPI

Chloe Beall Jacobs, PA-C

  • Physician Assistant
  • Lagrange, GA
National Provider Identifier
1518640523
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone
(706) 530-2151
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1524 Lafayette Pkwy
Lagrange, GA 30241-2566

Mailing address

1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone (706) 530-2151

Other practice location 1

301 Medical Dr Ste 504
LaGrange, GA 30240-4172
Phone (706) 812-2655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250303001869 GA Practitioner - Physician Assistant 4880115161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone (706) 530-2151

1825 Hwy 34 E
Suite 1200
Newnan, GA 30265-6416
Phone (770) 502-2121

1825 Hwy 34 E 1200
Newnan, GA 30265-6416

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

3471 Courtyard Way
Columbus, GA 31909-5379
Phone (706) 813-4420

35 Arbor Springs Ter
Newnan, GA 30265-4214
Phone (470) 323-5200

7301 Blackmon Rd
Columbus, GA 31909-4478
Phone (706) 383-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12836GAMDAnesthesiology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1518640523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412566",
            "telephone_number": "706-530-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412566",
            "telephone_number": "706-530-2151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Medical Dr Ste 504",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404172",
            "country_code": "US",
            "telephone_number": "706-812-2655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CHLOE",
        "middle_name": "BEALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.