Active NPI
Stacy Ann Paine, RD, LD
- Registered Dietitian
- Atlanta, GA
National Provider Identifier
1154576445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD002157
- Practice address
- 6674 Cadence Blvd
Atlanta, GA 30328-2874 - Phone
- (404) 937-3338
- Fax
- (404) 777-6469
- NPI assigned
- Dec 1, 2008
- Last updated
- Mar 21, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD002157 | GA | Primary |
Addresses
Primary practice location
6674 Cadence Blvd
Atlanta, GA 30328-2874
Mailing address
1061 Whispering Lakes TRL
Madison, GA 30650-6325
Phone (678) 773-1853
Other practice location 1
1061 Whispering Lakes Trl
Madison, GA 30650-6325
Phone (678) 773-1853
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD002157 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourished Well, LLC | Dietitian, Registered | Current | Accepting new patients |
| Oconee Nutrition Consultants, LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Beltline Weight Loss LLC | Past | Accepting new patients | |
| Body for Life LLC | Past | Accepting new patients | |
| Beltline Bariatric and Surgical Group LLC | Past | Accepting new patients | |
| Body for Life, LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
1093 Lake Oconee Pkwy
Ste 108
Eatonton, GA 31024
Phone (706) 473-5801
1051 Park Dr
Greensboro, GA 30642
Phone (678) 773-1853
Organizations & group practices 7
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.
-
- Registered Dietitian
- Madison, GA
- NPI 1780903096
Dietitian, Registered
-
- Surgery Physician
- Atlanta, GA
- NPI 1700232865
-
dba Beltline Weight Loss and Obesity Medicine LLC
- Obesity Medicine (Preventive Medicine) Physician
- Atlanta, GA
- NPI 1134686090
-
- Acute Care Nurse Practitioner
- Bartlett, TN
- NPI 1679869408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1154576445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 WHISPERING LAKES TRL",
"city": "MADISON",
"state": "GA",
"postal_code": "306506325",
"telephone_number": "678-773-1853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6674 CADENCE BLVD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303282874",
"telephone_number": "404-937-3338",
"fax_number": "404-777-6469"
}
],
"practiceLocations": [
{
"address_1": "1061 Whispering Lakes Trl",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "GA",
"postal_code": "306506325",
"country_code": "US",
"telephone_number": "678-773-1853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAINE",
"first_name": "STACY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-01",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD002157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.