Active NPI
Alicia Bennett Stromquist, PA-C, MMS
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1427012111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005265
- Practice address
- 20 Glenlake Parkway
Kaiser Permanente Glenlake Medical Center
Atlanta, GA 30328 - Phone
- (507) 334-1601
- Fax
- (507) 334-3071
- NPI assigned
- Apr 12, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10076 | MN | |
| Physician Assistant | 363A00000X | 005265 | GA | Primary |
Addresses
Primary practice location
20 Glenlake Parkway
Kaiser Permanente Glenlake Medical Center
Atlanta, GA 30328
Mailing address
3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-7070
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 983181045999 | Other | MN | PREFERRED ONE |
| 0122818 | Other | MN | MEDICA |
| HP59556 | Other | MN | HEALTH PARTNERS |
| 96G82BE | Other | MN | BCBS OF MN |
| 138025C572 | Other | MN | UCARE MN |
| 430612100 | Other | MN | MMSI |
| 434830300 | Medicaid | MN | |
| 410940705A029 | Other | MN | TRICARE/WPS |
Other names 1
- Miss Alicia Whitney Bennett
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649808000000",
"number": "1427012111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3495 PIEDMONT ROAD, NE",
"address_2": "NINE PIEDMONT CENTER",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30305",
"telephone_number": "404-364-7070",
"fax_number": "507-625-5971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 GLENLAKE PARKWAY",
"address_2": "KAISER PERMANENTE GLENLAKE MEDICAL CENTER",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30328",
"telephone_number": "507-334-1601",
"fax_number": "507-334-3071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROMQUIST",
"first_name": "ALICIA",
"middle_name": "BENNETT",
"name_prefix": "Ms.",
"credential": "PA-C, MMS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-12",
"last_updated": "2022-04-13",
"certification_date": "2022-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "10076",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "005265",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "983181045999",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0122818",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP59556",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "96G82BE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MN",
"identifier": "138025C572",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMSI",
"identifier": "430612100",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "434830300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/WPS",
"identifier": "410940705A029",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "20 Glenlake Parkway",
"address_2": "Kaiser Permanente Glenlake Medical Center",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "30328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ALICIA",
"last_name": "BENNETT",
"middle_name": "WHITNEY",
"prefix": "MISS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}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 Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.