Individual provider Active NPI

Stephanie Busby, M.D.

  • Surgery Physician
  • Memphis, TN
National Provider Identifier
1205199197
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
078401 Issued in GA
Practice address
University of Tennessee
910 Madison Avenue Suite 1031
Memphis, TN 38163-0001
Phone
(901) 448-7635
NPI assigned
Jun 17, 2012
Last updated
Mar 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 078401 GA Primary

Addresses

Primary practice location

University of Tennessee
910 Madison Avenue Suite 1031
Memphis, TN 38163-0001

Mailing address

Emory School of Medicine
69 Jesse Hill Drive SE
Atlanta, GA 30303-0001

Other practice location 1

902 N 7th St # 100
Cordele, GA 31015-3234
Phone (229) 276-2286

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180730000361 GA Practitioner - General Surgery 5193072783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
West Virginia University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Sep 1, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
David Kavtaradze MD Inc PastSince Mar 21, 2021 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: sbusby20208@direct.emory.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1205199197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EMORY SCHOOL OF MEDICINE",
            "address_2": "69 JESSE HILL DRIVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303030001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE",
            "address_2": "910 MADISON AVENUE SUITE 1031",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381630001",
            "telephone_number": "901-448-7635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N 7th St # 100",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153234",
            "country_code": "US",
            "telephone_number": "229-276-2286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "078401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.