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

Mrs. Caroline McCall Pennycook, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1780460808

Mrs. Caroline McCall Pennycook, PHYSICIANASSISTANT is a Physician Assistant in Atlanta, Georgia. Qualified in 2023, 3 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2023
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Practice location Address checks out

1100 Johnson Ferry Rd NE
Atlanta, GA 30342-1709
Phone: (404) 250-6691
Fax: (404) 250-8847
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11815 (GA)

Record details

NPI number1780460808
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedSeptember 5, 2023
Last updated in NPPESFebruary 15, 2026
Certification dateFebruary 15, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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