Individual provider Active NPI

Stephanie Michelle Garcia, FNP

  • Nurse Practitioner
  • Mount Airy, NC
National Provider Identifier
1417669037
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017861 Issued in NC
Practice address
865 W Lake Dr
Mount Airy, NC 27030-2102
Phone
(336) 719-6100
Fax
(336) 719-2313
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F11220036 NC
Family Nurse Practitioner 363LF0000X 5017861 NC
Nurse Practitioner 363L00000X 5017861 NC Primary

Addresses

Primary practice location

865 W Lake Dr
Mount Airy, NC 27030-2102

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

559 E Jackson Road Ext
Mount Airy, NC 27030-3108
Phone (336) 756-8244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230418002667 NC Practitioner - Nurse Practitioner 9032584362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

865 W Lake Dr
Mount Airy, NC 27030-2157
Phone (336) 719-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F11220036NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince May 5, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 5, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. Family Medicine CurrentSince May 5, 2023 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince May 5, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc Family Medicine Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

865 Westlake Dr
Mount Airy, NC 27030
Phone (336) 719-6100

2133 Rockford St
Ste 1400
Mount Airy, NC 27030
Phone (336) 673-6560

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

Interoperability endpoints

  • Direct secure messaging: sgarcia246408@direct.novanthealth.org

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 2

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1417669037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W LAKE DR",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302102",
            "telephone_number": "336-719-6100",
            "fax_number": "336-719-2313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 E Jackson Road Ext",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270303108",
            "country_code": "US",
            "telephone_number": "336-756-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "F11220036",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017861",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.