Individual provider Active NPI

Jessica Kinsey, PA-C

  • Physician Assistant
  • Chatsworth, GA
National Provider Identifier
1881400265
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12789 Issued in GA
Practice address
824 Gi Maddox Pkwy
Chatsworth, GA 30705-2147
Phone
(706) 695-0561
Fax
(706) 695-8678
NPI assigned
Dec 10, 2024
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 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 12789 GA Primary

Addresses

Primary practice location

824 Gi Maddox Pkwy
Chatsworth, GA 30705-2147

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703
Phone (706) 602-7800

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
I20250428003428 GA Practitioner - Physician Assistant 2668998162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Practice addresses (Care Compare)

824 Gi Maddox Pkwy
Chatsworth, GA 30705-2147
Phone (706) 695-0561

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12789GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jkinsey4570531@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1881400265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "30703",
            "telephone_number": "706-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 GI MADDOX PKWY",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052147",
            "telephone_number": "706-695-0561",
            "fax_number": "706-695-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, GA

Sources for this page

Verify at the official NPI Registry.