Individual provider Active NPI

Stephanie W Honeycutt, CPNP-AC

  • Acute Care Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1215167796
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN-NP159919 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 535-3611
Fax
(770) 535-7092
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN-NP159919 GA Primary
Pediatric Nurse Practitioner 363LP0200X RN159919 GA
Critical Care Pediatric Nurse Practitioner 363LP0222X RN159919 GA

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other identifiers 2

IdentifierTypeStateIssuer
003118858AMedicaidGA
650689OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP159919GAMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1215167796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-535-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONEYCUTT",
        "first_name": "STEPHANIE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "APRN-NP159919",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN159919",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "GA",
            "license": "RN159919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003118858A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "650689",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.