Individual provider Active NPI

Stacy Mastro, APRN

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1497284723
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN193501 Issued in GA
Practice address
440 Moreland Ave SE
Atlanta, GA 30316-1926
Phone
(404) 688-9300
NPI assigned
Jun 9, 2017
Last updated
Nov 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8445321-4405 UT
Family Nurse Practitioner 363LF0000X RN193501 GA Primary
Family Nurse Practitioner 363LF0000X 8445321-4405 UT
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

440 Moreland Ave SE
Atlanta, GA 30316-1926

Mailing address

2429 Martin Luther King Jr Dr SW # 4717
Atlanta, GA 30311-1713
Phone (404) 691-9580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, GA2 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
I20170911002629 UT Practitioner - Nurse Practitioner 3870866981 Reassigns benefits to 1 organization
I20220603000054 GA Practitioner - Nurse Practitioner 3870866981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Aug 1, 2017 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Minuteclinic LLC Nurse Practitioner CurrentSince Feb 18, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2017 Accepting new patients
Planned Parenthood Southeast, Inc Nurse Practitioner CurrentSince Nov 18, 2025 Accepting new patients
Planned Parenthood Southeast, Inc. Nurse Practitioner Past Accepting new patients

Locations

2429 Mlk Jr Dr SW
Atlanta, GA 30311
Phone (404) 691-3344

440 Moreland Ave SE
Atlanta, GA 30316
Phone (404) 688-9300

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1497284723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 MARTIN LUTHER KING JR DR SW # 4717",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111713",
            "telephone_number": "404-691-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MORELAND AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161926",
            "telephone_number": "404-688-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRO",
        "first_name": "STACY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8445321-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN193501",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8445321-4405",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.