Active NPI
Diana Stillwagon, RN
- Surgery Physician
- Chamblee, GA
National Provider Identifier
1407814015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 146008
- Practice address
- 3190 Northeast Expwy Access Rd
Chamblee, GA 30341 - Phone
- (770) 451-5990
- NPI assigned
- May 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 146008 | GA | Primary |
Addresses
Primary practice location
3190 Northeast Expwy Access Rd
Chamblee, GA 30341
Mailing address
4157 Darby Way
Duluth, GA 30096
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146008 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407814015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4157 DARBY WAY",
"city": "DULUTH",
"state": "GA",
"postal_code": "30096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3190 NORTHEAST EXPWY ACCESS RD",
"city": "CHAMBLEE",
"state": "GA",
"postal_code": "30341",
"telephone_number": "770-451-5990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLWAGON",
"first_name": "DIANA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "146008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chamblee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.