Individual provider Active NPI

Stephanie Eaton, MD

  • Pulmonary Disease Physician
  • Atlanta, GA
National Provider Identifier
1376512897
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
044204 Issued in GA
Practice address
960 Johnson Ferry Rd
Suite 500
Atlanta, GA 30342-1631
Phone
(404) 257-0006
Fax
(404) 851-1316
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X GA044204 GA
Pulmonary Disease Physician 207RP1001X 044204 GA Primary

Addresses

Primary practice location

960 Johnson Ferry Rd
Suite 500
Atlanta, GA 30342-1631

Mailing address

960 Johnson Ferry Rd
Suite 500
Atlanta, GA 30342-1631
Phone (404) 257-0006

Other identifiers 1

IdentifierTypeStateIssuer
00963234BMedicaidGA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address PCCA@PC8.gadirect.net Direct
Direct Messaging Address stephanie.eaton@northsidehospital.cernerdirect.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081226000145 GA Practitioner - Pulmonary Disease 0446312540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of California, Irvine, California College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

960 Johnson Ferry Rd
Suite 500
Atlanta, GA 30342-1630
Phone (404) 257-0006

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA044204GAMDSpecialist
044204GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Sep 1, 2012 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Sep 1, 2012 Accepting new patients
Northside Respiratory Care Specialist Current Accepting new patients
Atlanta Pulmonary Group, LLC Pulmonary Disease Past Accepting new patients
Critical Care Atlanta, LLC Past Accepting new patients
Saint Josephs Hospital of Atlanta Inc Past Accepting new patients

Locations

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1285 Upper Hembree Rd
Ste 205
Roswell, GA 30076
Phone (770) 521-1587

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5505 Peachtree Dunn
Ste 370
Sandy Springs, GA 30342

960 Johnson Fy Rd NE
Ste 500
Sandy Springs, GA 30342
Phone (404) 257-0006

5505 Pchtrdnwdy
#370
Sandy Springs, GA 30342
Phone (404) 257-0006

3350 Paddocks Pkwy
#3350A
Suwanee, GA 30024
Phone (678) 474-9633

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1376512897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-257-0006",
            "fax_number": "404-851-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-257-0006",
            "fax_number": "404-851-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "GA044204",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "044204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00963234B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PCCA@PC8.gadirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "960 Johnson Ferry Rd",
            "address_2": "Suite 500",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.eaton@northsidehospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "960 Johnson Ferry Rd",
            "address_2": "Suite 500",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.