Individual provider Active NPI

Stacy M Hendrix, FNP-C

  • Family Nurse Practitioner
  • Cedartown, GA
National Provider Identifier
1386120889
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN190785 Issued in GA
Practice address
118 E Girard Ave
Cedartown, GA 30125-2712
Phone
(678) 246-5174
NPI assigned
Jul 17, 2018
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN190785 GA Primary

Addresses

Primary practice location

118 E Girard Ave
Cedartown, GA 30125-2712

Mailing address

13570 N Main St
Trenton, GA 30752-2012
Phone (706) 956-2665

Other identifiers 1

IdentifierTypeStateIssuer
003147280AMedicaidGA

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
I20190311002136 GA Practitioner - Nurse Practitioner 6002154317 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
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1650 Chattahoochee Dr
Rockmart, GA 30153-2023
Phone (770) 684-7846

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN190785GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Oct 1, 2024 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Mar 1, 2021 Accepting new patients
Apogee Medical Group Georgia Inc CurrentSince Apr 1, 2024 Accepting new patients
Chronic Disease Management of Georgia, LLC CurrentSince Jul 10, 2024 Accepting new patients

Locations

3540 Cobb Pkwy NW
Acworth, GA 30101
Phone (770) 974-3911

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

704 Breedlove Dr
#A
Monroe, GA 30655
Phone (888) 772-0076

1650 Chattahoochee Dr
Rockmart, GA 30153
Phone (770) 684-7846

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Interoperability endpoints

  • Direct secure messaging: shendrix2951973@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

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": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1386120889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13570 N MAIN ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522012",
            "telephone_number": "706-956-2665",
            "fax_number": "706-657-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E GIRARD AVE",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252712",
            "telephone_number": "678-246-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN190785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147280A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedartown, GA

Sources for this page

Verify at the official NPI Registry.