Individual provider Active NPI

Jacquelyn N Harper, PA-C

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1679166367
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
12333 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2212
Phone
(404) 778-4889
Fax
(404) 778-0826
NPI assigned
Feb 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X
Surgical Physician Assistant 363AS0400X 12333 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2212

Mailing address

550 Peachtree St NE
Atlanta, GA 30308-2212
Phone (404) 778-4889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210611000206 DC Practitioner - Physician Assistant 1355741471 Reassigns benefits to 2 organizations
I20230411002892 VA Practitioner - Physician Assistant 1355741471 Reassigns benefits to 1 organization
I20241113000018 GA Practitioner - Physician Assistant 1355741471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12333GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Orthovirginia, Inc CurrentSince Jul 19, 2021 Accepting new patients
The Emory Clinic Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

6354 Walker Ln
Ste 300
Alexandria, VA 22310
Phone (703) 810-5210

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

1850 Town Center Pkwy
Ste 400
Reston, VA 20190
Phone (703) 234-1000

Interoperability endpoints

  • Direct secure messaging: jharper926843@direct.emory.org

Organizations & group practices 5

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": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1679166367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-778-4889",
            "fax_number": "404-778-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-778-4889",
            "fax_number": "404-778-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "JACQUELYN",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "12333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.