Individual provider Active NPI

Stephanie Jayne Henke, NP-C

  • Gerontology Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1205291408
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP206677 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd
Suite 825
Atlanta, GA 30342-1731
Phone
(404) 255-5595
Fax
(404) 252-2780
NPI assigned
Dec 15, 2015
Last updated
May 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN206677 GA
Gerontology Nurse Practitioner 363LG0600X NP206677 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd
Suite 825
Atlanta, GA 30342-1731

Mailing address

5673 Peachtree Dunwoody Rd
Suite 825
Atlanta, GA 30342-1731
Phone (404) 255-5595

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416002546 GA Practitioner - Nurse Practitioner 9931548575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP206677GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Mar 11, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 11, 2024 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#26019
Atlanta, GA 30303
Phone (404) 616-2219

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 1

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": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1205291408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 825",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-255-5595",
            "fax_number": "404-252-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 825",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-255-5595",
            "fax_number": "404-252-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "STEPHANIE",
        "middle_name": "JAYNE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206677",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "NP206677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.