Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

RAVEN PAULETTE ROSE PA
NPI 1912693771
Physician Assistant in Acworth, GA

Active since April 14, 2023PECOS Enrolled
3540 COBB PKWY NW, ACWORTH, GA 30101(770) 974-3911 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 13, 2026, Apr 14, 2023 (2 updates tracked since 2023).

About Raven Paulette Rose Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN PAULETTE ROSE PA (NPI 1912693771) is an individual physician assistant in Acworth, Georgia and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cartersville, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1912693771
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameRAVEN PAULETTE ROSECredential: PA
Location Address3540 COBB PKWY NWAcworth, GA 30101-4178
Mailing Address3809 Stonewall Dr NwKennesaw, GA 30152-2455 · (404) 645-4993
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateApril 14, 2023
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
NPPES CertifiedJuly 13, 2026
NPI 1912693771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

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.

3540 COBB PKWY NW, Acworth, GA 30101

Secondary Practice Location 1

Location 1200 Gentilly BlvdCartersville, GA 30120-8504 · Phone (470) 490-6510

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Raven Paulette Rose Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153835350
PECOS Enrollment IDI20250709003081
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
3540 COBB PKWY NW, SUITE 200
ACWORTH, GA 30101
Physical Therapist
3540 COBB PKWY NW, STE 200
ACWORTH, GA 30101
Physical Therapist
3540 COBB PKWY NW, STE 200
ACWORTH, GA 30101
Physical Therapist
3540 COBB PKWY NW, SUITE 200
ACWORTH, GA 30101
Physical Therapist
3540 COBB PKWY NW
ACWORTH, GA 30101
Nurse Practitioner (Family)
3540 COBB PKWY NW
ACWORTH, GA 30101
Nurse Practitioner
3540 COBB PKWY NW
ACWORTH, GA 30101
Otolaryngology
3540 COBB PKWY NW
ACWORTH, GA 30101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven Rose's NPI number?

The NPI number for Raven Rose is 1912693771. It was assigned to this individual provider in the NPPES registry on April 14, 2023.

Where is Raven Rose located?

Raven Rose practices at 3540 Cobb Pkwy NW, Acworth, GA 30101. The listed phone number is (770) 974-3911.

What is Raven Rose's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Raven Rose enrolled in Medicare?

Yes. Raven Rose is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Raven Rose was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.