Individual provider Active NPI

Ashley Airelle Wilson, PA-C

  • Physician Assistant
  • Duluth, GA
National Provider Identifier
1811715543
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12587 Issued in GA
Practice address
3790 Pleasant Hill Rd Ste 150
Duluth, GA 30096-5144
Phone
(678) 414-0400
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 12587 GA Primary

Addresses

Primary practice location

3790 Pleasant Hill Rd Ste 150
Duluth, GA 30096-5144

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

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
I20241129000256 GA Practitioner - Physician Assistant 7517492424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians
Urological Professional Services, LLCGroup PAC ID 9638391717, 72 clinicians

Practice addresses (Care Compare)

11835 Alpharetta Hwy
Roswell, GA 30076-4929
Phone (770) 475-7550

1600 Medical Way
Suite 220
Snellville, GA 30078-2160
Phone (770) 979-9427

3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone (678) 312-6800

3855 Pleasant Hill Rd
Suite 220
Duluth, GA 30096-8030
Phone (770) 979-9427

4450 Calibre Xing NW
Acworth, GA 30101-4103
Phone (770) 607-1893

5730 Glenridge Dr
Suite 200
Atlanta, GA 30328-5579
Phone (404) 256-1844

850 Lawrenceville Suwanee Rd
Suite 101
Lawrenceville, GA 30043-5483
Phone (770) 963-2451

900 Towne Lake Pkwy
Suite 200
Woodstock, GA 30189-1603
Phone (678) 494-9201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12587GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Urology, PA CurrentSince Nov 18, 2024 Accepting new patients
Georgia Urology PA CurrentSince Nov 18, 2024 Accepting new patients

Locations

3790 Pleasant Hill Rd
Ste 150
Duluth, GA 30096
Phone (678) 414-0400

1930 Brannan Rd
McDonough, GA 30253
Phone (678) 284-4040

900 Towne Lake Pkwy
Ste 200
Woodstock, GA 30189
Phone (678) 494-9201

Interoperability endpoints

  • Direct secure messaging: ashley.wilson.p1@direct.gupa.nextgenshare.com

Organizations & group practices 4

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 3

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1811715543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 PLEASANT HILL RD STE 150",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965144",
            "telephone_number": "678-414-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ASHLEY",
        "middle_name": "AIRELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.