Individual provider Active NPI

Stephanie Arkin, PA

  • Physician Assistant
  • Suwanee, GA
National Provider Identifier
1356996565
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10231 Issued in GA
Practice address
25 Old Peachtree Rd NW
Suwanee, GA 30024
Phone
(678) 225-7500
NPI assigned
Aug 5, 2019
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10231 GA Primary

Addresses

Primary practice location

25 Old Peachtree Rd NW
Suwanee, GA 30024

Mailing address

3726 Somerset RDG NW
Kennesaw, GA 30144-5716
Phone (770) 876-2628

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
I20210216000469 GA Practitioner - Physician Assistant 3779998273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia Col of Osteo Med, Sewanee, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Consultants of AtlantaGroup PAC ID 6305949090, 9 clinicians

Practice addresses (Care Compare)

1140 Hightower TRL
Atlanta, GA 30350-2923
Phone (770) 234-0981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10231GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First Class Healthcare LLC PastSince Sep 20, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1356996565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 SOMERSET RDG NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445716",
            "telephone_number": "770-876-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 OLD PEACHTREE RD NW",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "678-225-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARKIN",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.