Courtnay Staab, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7647 Issued in GA

Practice address

227 Riverstone Dr
Canton, GA 30114-5256

Phone

(770) 720-7733

Fax

(770) 720-7557

NPI assigned

Jun 22, 2015

Last updated

Dec 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mercer University School of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtnaystaab@cwhspc.allscriptsdirect.net
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10039275

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment NPD
• Cherokee Women's Health Specialist, P.C.

  • Obstetrics & Gynecology Physician
  • Canton, GA
  • NPI 1720115389
  NPD

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766880000000",
    "number": "1205218708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-720-7733",
            "fax_number": "770-720-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-720-7733",
            "fax_number": "770-720-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "COURTNAY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olukemi Onifade Spradling
• Brittany Mary Sproul, AGACNP-BC
• John A Sproviero, D.C.
• SSC Canton Operating Company LLC (Brian Center Health & Rehabilitation - Canton)
• Bailey St. Germain
• Stable Orthodontics of Hickory Flat, LLC
• Jessica Marie Stabler
• Tina Boyd Stacy, PHARMD
• Kayla Justine Stafford, FNP-C
• Asia Day Stanford, RN

• Physician Assistant in Canton, GA
• Providers in Canton, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.