James Edwin Stark, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

298 Issued in GA

Practice address

1755 The Exchange SE
Suite 375
Atlanta, GA 30339-7400

Phone

(770) 541-9988

Fax

(770) 541-9977

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1356492037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 THE EXCHANGE SE",
            "address_2": "SUITE 375",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397400",
            "telephone_number": "770-541-9988",
            "fax_number": "770-541-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 THE EXCHANGE SE",
            "address_2": "SUITE 375",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397400",
            "telephone_number": "770-541-9988",
            "fax_number": "770-541-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JAMES",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000041544A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Star Orthopedics and Spine of Atlanta
• Star Orthopedics and Spine of Georgia LLC.
• Star Quality Healthcare Services LLC
• Michael Stargel, MD
• Elizabeth Ann Stargell, NP-C
• Joshua Michael Stark, MD
• Mary Beth Stark, M.S.CCC-SLP
• Brianna Starkey, MA
• Nia Starks
• Robyn Starks

• Forensic Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Forensic Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.