P Praxis·MD
● Active Type 1 · Individual

MRS. Tasia Fortune, PA

Physician Assistant·Roswell, GA· NPI 1861048787 · Enumerated 2019 · 6 years on NPI
Fortune is 1 of 41 physician assistant providers in Roswell and 1 of 4616 in Georgia.
NPI age
6 years
Enumerated 2019-08-15
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA, SC
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-02-20
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 4616 active physician assistant providers in Georgia.

NPI age
6 years
↓ 2 yr below median (8 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 24% of peers with subspecialties

NPI lifetime · 2019 → 2026

2019-08Enumerated in NPPES
2019 2026

Where they practice

Practice location
4500 Hospital Blvd Ste 320
Roswell, GA 300760001
📞 7704104520fax 7704104525
Mailing address
4500 Hospital Blvd Ste 320
Roswell, GA 300760001
📞 7704104520fax 7704104525

Additional practice locations

2 secondary locations on file with NPPES.

Location 2
8 Richland Medical Park Dr Ste 300
Columbia, SC 292038008
📞 8034343800fax 8037442759
Location 3
110 S Main St
Boiling Springs, NC 280179797
📞 7044062369

Specialties

  • Physician Assistant Primary
    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 #11303SC license #3607 taxonomy 363A00000X
  • Student in an Organized Health Care Education/Training Program
    An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
    taxonomy 390200000X

Identifiers

TypeValueNotes
05 (SC) 4455PA
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

Recently enumerated nearby: 1 new physician assistant provider has been added in Roswell in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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