Individual provider Active NPI

Madeline Kate Shedd, PA-C

  • Physician Assistant
  • Woodstock, GA
National Provider Identifier
1487541090
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
120 Stonebridge Pkwy Ste 440
Woodstock, GA 30189-3768
Phone
(770) 250-7199
NPI assigned
Jun 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

120 Stonebridge Pkwy Ste 440
Woodstock, GA 30189-3768

Mailing address

120 Stonebridge Pkwy Ste 440
Woodstock, GA 30189-3768
Phone (770) 815-9978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251022002432 GA Practitioner - Physician Assistant 2062900905 Reassigns benefits to 1 organization
I20260410001051 UT Practitioner - Physician Assistant 2062900905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Dermatology AtlantaGroup PAC ID 1658623889, 2 clinicians
Karen Stolman MD PCGroup PAC ID 5890197933, 4 clinicians

Practice addresses (Care Compare)

120 Stonebridge Pkwy
Suite 440
Woodstock, GA 30189-3768
Phone (770) 250-7199

150 N Main St
Suite 202
Heber City, UT 84032-1671
Phone (435) 658-1013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Dermatology Atlanta CurrentSince Aug 11, 2025 Accepting new patients
Karen Stolman MD PC Past Accepting new patients

Locations

120 Stonebridge Pkwy
Ste 440
Woodstock, GA 30189
Phone (770) 250-7199

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": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1487541090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STONEBRIDGE PKWY STE 440",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893768",
            "telephone_number": "770-815-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STONEBRIDGE PKWY STE 440",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893768",
            "telephone_number": "770-250-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "MADELINE",
        "middle_name": "KATE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.