NPI age
6 years
Enumerated 2020-02-05
● Active
Type 1 · Individual
Jack Hanson Anzilotti, PAC
Anzilotti is 1 of 128 physician assistant providers in Atlanta and 1 of 640 in Georgia.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-07-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 640 active physician assistant providers in Georgia.
NPI age
6 years
↓ 7 yr below median (13 yr)
State licenses
2 states
Top 89% — 10% of peers are multi-state
Subspecialties
0
37% of peers hold subspecialties
NPI lifetime · 2020 → 2026
2020-02Enumerated in NPPES
2020
2026
Where they practice
Practice location
980 Johnson Ferry Rd Ste 800
Atlanta, GA 303421608
Mailing address
980 Johnson Ferry Rd
Atlanta, GA 303421626
Additional practice locations
1 secondary location on file with NPPES.
Location 2
89 W Copeland Dr
Orlando, FL 328062002
Specialties
-
Physician Assistant PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (FL) | 105528800 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.