Individual provider Active NPI

Avery Jeffreys

  • Medical Physician Assistant
  • Cumming, GA
National Provider Identifier
1659227957
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4150 Deputy Bill Cantrell Memorial Rd
Cumming, GA 30040
Phone
(770) 292-3045
NPI assigned
Mar 9, 2026
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X GA Primary

Addresses

Primary practice location

4150 Deputy Bill Cantrell Memorial Rd
Cumming, GA 30040

Mailing address

608 Bayberry PT
Canton, GA 30115-8518

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
I20260410001146 GA Practitioner - Physician Assistant 9739654351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Ear Nose and Throat PCGroup PAC ID 9830403229, 15 clinicians

Practice addresses (Care Compare)

4150 Deputy Bill Cantrell Memorial
Suite 260
Cumming, GA 30040
Phone (770) 292-3045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1659227957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 BAYBERRY PT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "770-292-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREYS",
        "first_name": "AVERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.