Stephanie Evans Wellborn, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

007185 Issued in GA

Practice address

1800 Northside Forsyth Dr Ste 450
Cumming, GA 30041

Phone

(770) 444-2191

NPI assigned

Jul 7, 2014

Last updated

Jan 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stephaniewellborn@napc.allscriptsdirect.net

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.

• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment Care Compare group
• Myfamilydoc LLC

  • Family Medicine Physician
  • Demorest, GA
  • NPI 1346580982
  Medicare reassignment
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Northside Womens Group LLC

  dba Northside Womens Practice LLC

  • Obstetrics & Gynecology Physician
  • Canton, GA
  • NPI 1245193358
  NPD (past)
• Southeast Medical Group, P.C.

  • Medical Physician Assistant
  • Alpharetta, GA
  • NPI 1558803486
  NPD (past)

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1063828408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NORTHSIDE FORSYTH DR STE 450",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418483",
            "telephone_number": "770-444-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NORTHSIDE FORSYTH DR STE 450",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-444-2191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1070 Historic Hwy 441",
            "address_2": "Suite D & E",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "30535",
            "country_code": "US",
            "telephone_number": "706-778-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLBORN",
        "first_name": "STEPHANIE",
        "middle_name": "EVANS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "007185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Addington Weinberg, OTR.L
• Sara Judith Weirich, OT
• Ellen Welch, P.T.
• Karen Welch, PTA
• Wellborn Counseling, LLC
• Wellstreet of Georgia PC
• Wellstreet of Georgia PC
• Michele Wenzel
• West Forsyth Internal Medicine
• David Miller Westfall, CNIM

• 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 Jan 25, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.