Stacy McQuillen, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN254830 Issued in GA

Practice address

505 Dacula Rd
Dacula, GA 30019-2125

Phone

(678) 407-8750

NPI assigned

Mar 15, 2022

Last updated

Mar 15, 2022By 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• TLC of Georgia LLC

  dba The Little Clinic

  • Family Nurse Practitioner
  • Jefferson, GA
  • NPI 1750677241
  NPD

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1326796749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192125",
            "telephone_number": "678-407-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192125",
            "telephone_number": "678-407-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILLEN",
        "first_name": "STACY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN254830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan McKee, OTR/L
• Shelli-Ann McKenzie
• Sarah Elizabeth McKinney
• Jennifer Blair McMichael, DPT
• Mary Lu McNeill, MD
• Allisan Faye Meadows, FPN-BC
• Med Injury LLC
• Adelaide Mendoza, PCE
• Ethan Zachariah Merrow
• Christian Lee Merz, M.D.

• Family Nurse Practitioner in Dacula, GA
• Providers in Dacula, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.