CMS NPPES uses NUCC taxonomy code 363AM0700X for provider records classified as Medical within Physician Assistant. The taxonomy identifies the category reported on the NPI record; it does not by itself verify services offered, current...
taxonomy 363AM0700X
Physician Assistant
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
GA license #11871taxonomy 363A00000X
Medicare directory context
Attributes below come from the CMS Doctors & Clinicians dataset used by Medicare Care Compare,
retrieved 2026-08-21. They apply only to this clinician's public Medicare listing.
Medicare specialties
Physician Assistant
Largest Medicare group
3072 members
Largest listed enrollment group
Facility affiliations reported by CMS
Cep America Llc
Wellstar Medical Group Llc
Medicare listing data does not guarantee that a clinician is accepting new patients or that a service is covered.
View the CMS dataset →
Practice context
Part of a multi-provider practice. 312 other active providers share this practice address in NPPES.
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