Individual provider Active NPI

Stephanie Marla Higdon, FNP-BC

  • Family Nurse Practitioner
  • Duluth, GA
National Provider Identifier
1346715927
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN223104 Issued in GA
Practice address
3660 Howell Ferry Rd BLDG B
Duluth, GA 30096-3178
Phone
(770) 670-4640
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN223104 GA
Family Nurse Practitioner 363LF0000X RN223104 GA Primary

Addresses

Primary practice location

3660 Howell Ferry Rd BLDG B
Duluth, GA 30096-3178

Mailing address

705 Standing Turkey CT
Woodstock, GA 30189-2593
Phone (678) 431-1998

Other identifiers 1

IdentifierTypeStateIssuer
2018019076OtherAMERICAN NURSES CREDINTIALING CENTER CERTIFICATION

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
I20210525001906 GA Practitioner - Nurse Practitioner 0345670782 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascend Medical Georgia II PCGroup PAC ID 0547657181, 16 clinicians

Practice addresses (Care Compare)

619 Rankin St NE
Atlanta, GA 30308-2920
Phone (404) 994-1364

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince May 4, 2021 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 4, 2021 Accepting new patients
Regional Healthcare Group LLC CurrentSince Sep 23, 2024 Accepting new patients
Guardian Biologics LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1346715927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 STANDING TURKEY CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892593",
            "telephone_number": "678-431-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 HOWELL FERRY RD BLDG B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963178",
            "telephone_number": "770-670-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGDON",
        "first_name": "STEPHANIE",
        "middle_name": "MARLA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN223104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN223104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDINTIALING CENTER CERTIFICATION",
            "identifier": "2018019076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.