Individual provider Active NPI

Stephen George Pappas, M.D.

  • Neurology Physician
  • Brunswick, GA
National Provider Identifier
1033198809
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
029509 Issued in GA
Practice address
2600 Parkwood Dr
Brunswick, GA 31520-4725
Phone
(912) 264-9999
Fax
(912) 264-8099
NPI assigned
Jan 11, 2006
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 029509 GA
Neurology Physician 2084N0400X 029509 GA Primary

Addresses

Primary practice location

2600 Parkwood Dr
Brunswick, GA 31520-4725

Mailing address

2600 Parkwood Dr
Brunswick, GA 31520-4725
Phone (912) 264-9999

Other identifiers 4

IdentifierTypeStateIssuer
1093986192OtherGAGROUP NPI
00342922AMedicaidGA
611242OtherGABLUE CROSS BLUE SHIELD
130016081OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120119000854 GA Practitioner - Neurology 7911069950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
029509GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M.J. Martelli, M.D. Past Accepting new patients
Marc W. Eaton, PH.D., P.C. Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1033198809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204725",
            "telephone_number": "912-264-9999",
            "fax_number": "912-264-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204725",
            "telephone_number": "912-264-9999",
            "fax_number": "912-264-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "STEPHEN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "029509",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "029509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1093986192",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00342922A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "611242",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130016081",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.