Individual provider Active NPI

Jacob Lunsford, PA-C

  • Physician Assistant
  • Cochran, GA
National Provider Identifier
1770937104
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8441 Issued in GA
Practice address
109 S 3Rd St
Cochran, GA 31014-6718
Phone
(478) 934-4988
Fax
(478) 934-4989
NPI assigned
Apr 22, 2016
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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 8441 GA Primary

Addresses

Primary practice location

109 S 3Rd St
Cochran, GA 31014-6718

Mailing address

109 S 3Rd St
Cochran, GA 31014-6718
Phone (478) 934-4988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160722000504 VA Practitioner - Physician Assistant 0840583233
I20171115002929 GA Practitioner - Physician Assistant 0840583233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
55.58 of 100Reported as group
Quality
51.64
Improvement activities
0
Cost
70.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8441GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Candler County CurrentSince May 15, 2019 Accepting new patients
Careconnect Health, Inc. CurrentSince Aug 17, 2025 Accepting new patients
Hospital Authority of Candler County Past Accepting new patients
Hospital Authority of Candler County Past Accepting new patients

Locations

109 S 3rd St
Cochran, GA 31014
Phone (478) 934-4988

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

Organizations & group practices 6

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1770937104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S 3RD ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146718",
            "telephone_number": "478-934-4988",
            "fax_number": "478-934-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S 3RD ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146718",
            "telephone_number": "478-934-4988",
            "fax_number": "478-934-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNSFORD",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cochran, GA

Sources for this page

Verify at the official NPI Registry.