Ebonne Quiller, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11768 Issued in GA

Practice address

1834 Clairmont Rd Unit 100
Decatur, GA 30033-3405

Phone

(404) 634-4443

NPI assigned

Oct 12, 2022

Last updated

Jul 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Allcare Ga PCGroup PAC ID 2668907940, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebonne.quiller.1@33029.direct.athenahealth.com

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.

• Allcare Ga PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1972080554
  Medicare reassignment Care Compare group NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group
• Resurgia Health Solutions PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1851702153
  Medicare reassignment
• Ennoble HC DMV LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Fulton, MD
  • NPI 1104492115

  GA

  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment
• Capital Healthcare PC

  • Primary Care Clinic/Center
  • Alexandria, VA
  • NPI 1811239627
  NPD (past)
• Itrust Cares LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, SC
  • NPI 1225751068
  NPD (past)
• Itrust Wellness Group Therapeutics

  • Psychiatry Physician
  • Greenville, SC
  • NPI 1184228413
  NPD (past)

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1902522956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 STILLHOUSE CREEK DR SW",
            "address_2": "APT 843",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 CLAIRMONT RD UNIT 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333405",
            "telephone_number": "404-634-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLER",
        "first_name": "EBONNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quality Care & Advocacy Group, Inc.
• Quality Screening Mobile Lab LLC
• Saydra-Lynn Cherelle Quashie
• Emily Madison Queen, PHARMD
• Maria Fernanda Quezada, MSW
• Raquel Alexandra Quinones Ubarri, LMSW
• Luis Antonio Quinones, M.D.
• Elmer Luis Quintero, M.D.
• Jacqueline O Quintero, DPM
• Quintessential Foot Care, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.