Jessica Ebong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7667 Issued in GA

Practice address

148 Bill Carruth Pkwy
Hiram, GA 30141-3754

Phone

(470) 610-0145

NPI assigned

Aug 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Otolaryngology Physician
  • Austell, GA
  • NPI 1982900551
  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319
  NPD (past)

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

• Paulding Medical Center, Inc.

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435
  Care Compare affiliation

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1689406597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 BILL CARRUTH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413754",
            "telephone_number": "470-610-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Stonebridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342244",
            "country_code": "US",
            "telephone_number": "943-202-7132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBONG",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jebong581998@directwellstar.org",
            "affiliation": "N",
            "address_1": "148 Bill Carruth Pkwy",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301413754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara Dozier
• Dr Baley Chiropractic, LLC
• Dr. Jay Rosa, Chiropractor, LLC
• Nayana Christine Dubier, DDS
• Aliaksandr Dzmitryieu, M.D.
• Anahid A Ebrahimi, PA-C
• Ijeoma Genevieve Eccles-James, MSC, MD
• Vernon Edmonds
• Vanessa Edwards-Benjamin, LAPC
• Timothy Chad Ehmer, DC

• Physician Assistant in Hiram, GA
• Providers in Hiram, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.