Active NPI
Stacy Page, CSA
- Surgical Assistant
- Evans, GA
National Provider Identifier
1487969416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 1514
- Practice address
- 664 Mickelson Way
Evans, GA 30809-5198 - Phone
- (706) 840-9107
- NPI assigned
- Aug 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 1514 | GA | Primary |
Addresses
Primary practice location
664 Mickelson Way
Evans, GA 30809-5198
Mailing address
664 Mickelson Way
Evans, GA 30809-5198
Phone (706) 840-9107
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1514 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444780800000",
"number": "1487969416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 MICKELSON WAY",
"city": "EVANS",
"state": "GA",
"postal_code": "308095198",
"telephone_number": "706-840-9107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "664 MICKELSON WAY",
"city": "EVANS",
"state": "GA",
"postal_code": "308095198",
"telephone_number": "706-840-9107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "STACY",
"name_prefix": "Mrs.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-14",
"last_updated": "2015-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "GA",
"license": "1514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
- Ashley Sade Oviawe, PHARMD
- Leslie Johnson Owen, LPC
- Ralph G Owen Jr., MD
- Christopher P Owens
- Cindy Pafford
- Pain Management & Rehabilitation Specialists, PC (PM&R Specialists, PC)
- Pain Management & Rehabilitation Specialists, PC
- Gregory Charles Pancake, PT, DPT
- Erin Park, LPC
- Bailey Olivia Parker, OT, MOT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.