Individual provider Active NPI

Nanci R Stauffer, M.D.

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1396783718
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
045633 Issued in GA
Practice address
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone
(404) 256-2593
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 045633 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE
Atlanta, GA 30322-1060

Mailing address

2835 Brandywine Rd
#300
Atlanta, GA 30341
Phone (404) 256-2593

Other practice location 1

5455 Meridian Mark Rd
Ste 530
Atlanta, GA 30342
Phone (404) 256-2593

Other identifiers 1

IdentifierTypeStateIssuer
00799466AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sibley@choa.gadirect.com Health Information Exchange (HIE) Children's Healthcare of Atlanta

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045633GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Fulton Regional Medical Center Pro Fee Billing, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nanci.stauffer@westgahealth.gadirect.net

Organizations & group practices 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1396783718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "#300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-256-2593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5455 Meridian Mark Rd",
            "address_2": "Ste 530",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30342",
            "country_code": "US",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "NANCI",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "045633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00799466A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "1405 Clifton Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.