Rayvelle Antoinette Stallings, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

410401 Issued in GA

Practice address

1626 Jeurgens CT
Norcross, GA 30093-2219

Phone

(816) 843-5810

Fax

(816) 843-6415

NPI assigned

May 15, 2016

Sex

Female

Sole proprietor

Yes

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Georgetown University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pruitthealth Physicians Services LLCGroup PAC ID 8123327061, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pruitthealth Physicians Services, LLC

  • Internal Medicine Physician
  • Norcross, GA
  • NPI 1043676299

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Pruitthealth Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Norcross, GA
  • NPI 1013152933
  Medicare reassignment NPD
• Pruitthealth - Ashburn LLC

  • Skilled Nursing Facility
  • Ashburn, GA
  • NPI 1851347108
  NPD (past)
• Pruitthealth - Sylvester, LLC

  • Skilled Nursing Facility
  • Sylvester, GA
  • NPI 1700299922
  NPD (past)

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1154778629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "816-843-5810",
            "fax_number": "816-843-6415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 Randall H Whiddon Dr",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "GA",
            "postal_code": "317145410",
            "country_code": "US",
            "telephone_number": "770-279-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Monk St",
            "address_purpose": "LOCATION",
            "city": "Sylvester",
            "state": "GA",
            "postal_code": "317917246",
            "country_code": "US",
            "telephone_number": "229-776-5541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "RAYVELLE",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-15",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "410401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.