Organization Active NPI

R Little Enterprises Inc

Doing business as Connie Stapleton PHD

  • Clinical Psychologist
  • Augusta, GA
National Provider Identifier
1164464814
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2412 Issued in GA
Legal business name
R LITTLE ENTERPRISES INC
Doing business as
Connie Stapleton PHD
Practice address
2915 Professional Pkwy
Suite C
Augusta, GA 30907-6521
Phone
(706) 364-5228
Fax
(706) 364-5229
NPI assigned
Jun 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Connie Stapleton, PHD
Title
Psychologist
Phone
(706) 364-5228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2412 GA Primary

Addresses

Primary practice location

2915 Professional Pkwy
Suite C
Augusta, GA 30907-6521

Mailing address

2915 Professional Pkwy
Suite C
Augusta, GA 30907-6521
Phone (706) 364-5228

Other identifiers 2

IdentifierTypeStateIssuer
52821111-001OtherGABCBS ID#
497373OtherGAVALUE OPTIONS

Other names 1

  • CONNIE STAPLETON PHD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060214000074 GA Part B Supplier - Clinic/Group Practice 6709891658 Receives reassigned benefits from 1 practitioner
Practice locations: Acworth, GA

National Provider Directory

National Provider Directory

Locations

5944 Highway 92
Ste 100
Acworth, GA 30102
Phone (706) 364-5228

2820 Hillcreek Dr
#A
Augusta, GA 30909
Phone (706) 364-5228

2915 Professional Pkwy
Ste C
Augusta, GA 30907
Phone (706) 364-5228

3830 Washington Rd
Martinez, GA 30907
Phone (762) 222-7629

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164464814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 PROFESSIONAL PKWY",
            "address_2": "SUITE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309076521",
            "telephone_number": "706-364-5228",
            "fax_number": "706-364-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 PROFESSIONAL PKWY",
            "address_2": "SUITE C",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309076521",
            "telephone_number": "706-364-5228",
            "fax_number": "706-364-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R LITTLE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STAPLETON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "706-364-5228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "2412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "52821111-001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "497373",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONNIE STAPLETON PHD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.