Individual provider Active NPI

Joy Stephanie Daise, PA-C

  • Medical Physician Assistant
  • McDonough, GA
National Provider Identifier
1154303451
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8967 Issued in GA
Practice address
141 Henry Pkwy
McDonough, GA 30253-6636
Phone
(770) 288-7692
Fax
(770) 288-7690
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8967 GA Primary

Addresses

Primary practice location

141 Henry Pkwy
McDonough, GA 30253-6636

Mailing address

141 Henry Pkwy
McDonough, GA 30253-6636
Phone (770) 288-7692

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
I20240403000127 GA Practitioner - Physician Assistant 9234028069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Apr 1, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Apr 1, 2024 Accepting new patients
Surgical Care Associates Past Accepting new patients
Health Access Network Past Accepting new patients
Prospect Health Access Network, Inc. Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#26019
Atlanta, GA 30303
Phone (404) 616-2219

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1154303451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 HENRY PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536636",
            "telephone_number": "770-288-7692",
            "fax_number": "770-288-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HENRY PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536636",
            "telephone_number": "770-288-7692",
            "fax_number": "770-288-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAISE",
        "first_name": "JOY",
        "middle_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.