John K Stevens, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

045633 Issued in GA

Practice address

355 Tower Rd NE Ste 204
Marietta, GA 30060-9413

Phone

(404) 256-2593

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Childrens Healthcare of Atlanta Cardiology Inc

  • Pediatric Cardiology Physician
  • Atlanta, GA
  • NPI 1235148727
  Medicare reassignment NPD
• North Fulton Regional Medical Center Pro Fee Billing, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1013142744
  NPD (past)
• Southern Regional Health System, Inc

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1831190958
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1336180355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "#300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609413",
            "telephone_number": "404-256-2593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5455 Meridian Mark Rd",
            "address_2": "Ste 530",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30342",
            "country_code": "US",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "045633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00542022A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "355 Tower Rd NE Ste 204",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300609413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edward A Stettner, MD
• Steven R.Kilgore, LCSW
• Eleanor Kathryn Stevenback
• Amy M. Stevens, LPC
• Gregory Stevens, PHD
• Stevenson Hearing Healthcare, LLC
• John Mark Stevenson Sr., HAD-F
• Laura Stevenson, RN
• Kayla Steward, PH.D.
• Donna Leigh Stewart Miles, MD

• Pediatric Cardiology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.