MRS. ELISABETH JACKSON GAINES PA-C NPI 1194706234

NPI Information

  • NPI: 1194706234
  • Provider Name: MRS. ELISABETH JACKSON GAINES, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4586 TIMBER RIDGE DR STE 200
    DOUGLASVILLE, GA
    ZIP 30135
  • Phone: (770) 942-0457

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NPI Details

MRS. Elisabeth Jackson Gaines, PA-C is a physician assistant in Douglasville, GA with 26 years of experience. The provider is 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 trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MRS. Elisabeth Jackson Gaines, PA-C NPI is 1194706234. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:1999

The provider's business location address is:

4586 TIMBER RIDGE DR STE 200
DOUGLASVILLE, GA
ZIP 30135-514
Phone: (770) 942-0457
Fax: (770) 942-7699

The NPI 1194706234 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 11/7/2005 and was last updated on 12/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant003791GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003101476BMEDICAIDGEORGIA
2202I970546OTHERGEORGIAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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