Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jelisa Carroll

Individual provider Family Medicine Physician · NPI 1396271292

Jelisa Carroll is a Family Practice in Brunswick, Georgia. Graduated from Philadelphia College of Osteopathic Medicine in 2013, 13 years ago. Practices with Cooperative Healthcare Services Inc, a 236-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
13
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
GA
In the registry since
2017
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Practice location Address checks out

2916 Glynn Ave
Brunswick, GA 31520-4844
Phone: (912) 466-5850
Fax: (912) 267-7139
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 86289 (GA)

Record details

NPI number1396271292
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 11, 2017
Last updated in NPPESJuly 12, 2024
Certification dateJuly 12, 2024
Mailing address2916 Glynn Ave, Brunswick, GA 31520-4844

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2013 (13 years in practice)
Group practice Cooperative Healthcare Services Inc — 236 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Brunswick