Jon L Stanford, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

065186 Issued in GA

Practice address

119 Ambulance Dr # DT
Suite 202
Carrollton, GA 30117-3857

Phone

(770) 834-3336

Fax

(770) 832-2331

NPI assigned

May 22, 2006

Last updated

Aug 8, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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

Specialty

General Surgery

Education

Ohio State University College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
• Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787
  Medicare reassignment Care Compare group NPD
• Carrollton Surgical Group, P. a.

  • Surgery Physician
  • Carrollton, GA
  • NPI 1417931825
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tanner Medical Center, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Carrollton, GA
  • NPI 1801883780
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1336193200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE",
            "address_2": "SUITE 302",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174454",
            "telephone_number": "770-834-3336",
            "fax_number": "770-832-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR # DT",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-834-3336",
            "fax_number": "770-832-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "JON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "24016",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "065186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T81177",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Therapy Services, Inc.
• Odessa Kirsten Spraggins, MD
• Keatrina T Springer, CPNP
• Cindy White Spruell, PHARM.D.
• Iris Stanford, DPT
• Krista J Stapleton, O.D.
• Lorie Maxwell Startup, NP-C
• Ray Stedwell, M.D.
• Christina Lynn Stein, A.P.R.N., B.C., N.P.
• Jonah Levi Stephens, PHARMD

• Surgery Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.