Individual provider Active NPI

Stephanie Faye Bennett

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1043086879
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RN251069 Issued in GA
Practice address
1014 Forsyth St
Macon, GA 31201-2051
Phone
(478) 633-8100
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X RN251069 GA
Family Medicine Physician 207Q00000X RN251069 GA Primary

Addresses

Primary practice location

1014 Forsyth St
Macon, GA 31201-2051

Mailing address

5661 Ocmulgee East Blvd
Macon, GA 31217-5797
Phone (478) 960-9592

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116001741 GA Practitioner - Nurse Practitioner 4880046820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabriel Primary CareGroup PAC ID 5294197265, 7 clinicians

Practice addresses (Care Compare)

101 Gateway Dr
Macon, GA 31210-1141
Phone (478) 378-0829

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN251069GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Primary Care Family Medicine CurrentSince Jan 8, 2024 Accepting new patients

Locations

101 Gateway Dr
Macon, GA 31210
Phone (478) 210-1670

Interoperability endpoints

  • Direct secure messaging: sbennett434675@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1043086879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5661 OCMULGEE EAST BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312175797",
            "telephone_number": "478-960-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 FORSYTH ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012051",
            "telephone_number": "478-633-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STEPHANIE",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "GA",
            "license": "RN251069",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN251069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.