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

Jessica Ebong, PA-C

Individual provider Physician Assistant · NPI 1689406597

Jessica Ebong, PA-C is a Physician Assistant in Hiram, Georgia. Qualified in 2024, 2 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

148 Bill Carruth Pkwy
Hiram, GA 30141-3754
Phone: (470) 610-0145
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8901 Stonebridge Blvd, Douglasville, GA 30134-2244 — (943) 202-7132

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7667 (GA)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1689406597
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 19, 2024
Last updated in NPPESMarch 24, 2025
Certification dateMarch 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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