Individual provider Active NPI

Molly Musselwhite, PA-C

  • Physician Assistant
  • Jefferson, GA
National Provider Identifier
1619655214
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11732 Issued in GA
Practice address
528 Panther Dr
Jefferson, GA 30549-5400
Phone
(706) 395-3030
NPI assigned
Jul 5, 2023
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 11732 GA Primary

Addresses

Primary practice location

528 Panther Dr
Jefferson, GA 30549-5400

Mailing address

1587 Adams Ave
Braselton, GA 30517-4322
Phone (678) 206-6780

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
I20230831002916 GA Practitioner - Physician Assistant 5193188514 Reassigns benefits to 2 organizations

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
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

110 Banks Crossing Dr
Suite 110
Commerce, GA 30529-6606
Phone (762) 244-5310

1305 Jennings Mill Rd
Suite 120
Watkinsville, GA 30677-7241
Phone (706) 410-2005

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

340 Exchange Blvd
Bethlehem, GA 30620-1759
Phone (706) 413-4500

3711 Village Way
Suite a
Braselton, GA 30517-2201
Phone (470) 615-2661

485 Hwy 29 N
Athens, GA 30601-5583
Phone (706) 438-4080

528 Panther Dr
Jefferson, GA 30549-5400
Phone (706) 395-3030

749 Lanier Ave W
Suite 1850
Fayetteville, GA 30214-7658
Phone (770) 835-4925

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

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

528 Panther Dr
Jefferson, GA 30549
Phone (706) 387-5555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1619655214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 ADAMS AVE",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305174322",
            "telephone_number": "678-206-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 PANTHER DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305495400",
            "telephone_number": "706-395-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSELWHITE",
        "first_name": "MOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.