Individual provider Active NPI

Stephanie Nadeau, NP-C

  • Family Nurse Practitioner
  • Dawsonville, GA
National Provider Identifier
1487049359
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN215537 Issued in GA
Practice address
332 Grey Swan Way
Dawsonville, GA 30534-8720
Phone
(770) 826-2987
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN215537 GA
Family Nurse Practitioner 363LF0000X RN215537 GA Primary

Addresses

Primary practice location

332 Grey Swan Way
Dawsonville, GA 30534-8720

Mailing address

332 Grey Swan Way
Dawsonville, GA 30534-8720
Phone (770) 826-2987

Other identifiers 2

IdentifierTypeStateIssuer
F1214243OtherGAAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION
RN215537OtherGAGEORGIA STATE BOARD OF NURSING LICENSURE

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
I20150601001232 GA Practitioner - Nurse Practitioner 5496076663 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN215537GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Group of Georgia, P. C. CurrentSince Dec 20, 2024 Accepting new patients
Concierge Medicine LLC Past Accepting new patients

Locations

5 Concourse Pkwy
Ste 3100
Sandy Springs, GA 30328
Phone (855) 492-7642

Organizations & group practices 2

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1487049359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 GREY SWAN WAY",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348720",
            "telephone_number": "770-826-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 GREY SWAN WAY",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348720",
            "telephone_number": "770-826-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "STEPHANIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN215537",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION",
            "identifier": "F1214243",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE BOARD OF NURSING LICENSURE",
            "identifier": "RN215537",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.