Individual provider Active NPI

Jessica Enfinger, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1609599703
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12214 Issued in GA
Practice address
1110 W Peachtree St NW Ste 950
Atlanta, GA 30309-3609
Phone
(404) 847-4210
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 12214 GA Primary

Addresses

Primary practice location

1110 W Peachtree St NW Ste 950
Atlanta, GA 30309-3609

Mailing address

1110 W Peachtree St NW Ste 950
Atlanta, GA 30309-3609
Phone (404) 847-4210

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
I20240606000791 GA Practitioner - Physician Assistant 3072055011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1110 W Peachtree St NW
Atlanta, GA 30309-3609

4800 Olde Towne Pkwy
Marietta, GA 30068-4424

960 Johnson Ferry Rd
Atlanta, GA 30342-1601

960 Johnson Fy Rd NE
Suite 130
Atlanta, GA 30342-1601
Phone (404) 300-2990

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Colon & Rectall Surgical Associates PC PastSince Mar 24, 2024 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1609599703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W PEACHTREE ST NW STE 950",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093609",
            "telephone_number": "404-847-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PEACHTREE ST NW STE 950",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093609",
            "telephone_number": "404-847-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENFINGER",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.