Stephen Hartle, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7350 Issued in GA

Practice address

2576 Peachtree Pkwy
Suite 100
Cumming, GA 30041

Phone

(770) 888-8777

Fax

(770) 888-8779

NPI assigned

Oct 15, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment
• Physicians' Immediate Med

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1942240346
  NPD
• Reddy Urgent Care - Royston LLC

  • Urgent Care Clinic/Center
  • Royston, GA
  • NPI 1093847444
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1013311307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2576 PEACHTREE PKWY",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-888-8777",
            "fax_number": "770-888-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2576 PEACHTREE PKWY",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-888-8777",
            "fax_number": "770-888-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLE",
        "first_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Harris, NP
• Kara Livingston Harris, PA-C
• Kendra Harris
• Melinda Harris
• Lara Renee Hart, M.D.
• Angela Marie Hartley
• Farid Hasani
• Mark Wayne Hastings, PHARM.D.
• Toya E Hauf, LCSW, CSW
• Inga Haut, MAT, BCBA

• Medical Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.