Individual provider Active NPI

Nicole Renee Stallings, CRNP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1538416748
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN305661 Issued in GA
Practice address
1800 Howell Mill Rd NW Ste 500
Atlanta, GA 30318-2594
Phone
(404) 367-3350
NPI assigned
Aug 7, 2012
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 RN305661 GA Primary
Adult Health Nurse Practitioner 363LA2200X SP012160 PA

Addresses

Primary practice location

1800 Howell Mill Rd NW Ste 500
Atlanta, GA 30318-2594

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-4600

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20120823000017 PA Practitioner - Nurse Practitioner 2163679366 Reassigns benefits to 2 organizations
I20230511000608 GA Practitioner - Nurse Practitioner 2163679366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1800 Howell Mill Rd
Suite 500
Atlanta, GA 30318-2594
Phone (404) 425-7310

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP012160PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 5, 2019 Accepting new patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Jun 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 5, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 20, 2020 Accepting new patients
Piedmont Providers LLC CurrentSince Aug 5, 2024 Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince Jun 1, 2023 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan, Inc CurrentSince Jul 20, 2020 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

1800 Howell Mill Rd NW
Ste 500
Atlanta, GA 30318
Phone (404) 240-9700

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

1521 Hickory Flat Hwy
Ste 100
Canton, GA 30115
Phone (770) 479-1870

790 Church St NE
Ste 335
Marietta, GA 30060
Phone (770) 590-8311

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3401 N Broad St
#M
Philadelphia, PA 19140

5501 Old York Rd
Bldg 2ND
Philadelphia, PA 19141
Phone (215) 456-3880

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

9880 Bustleton Ave
Ste 208
Philadelphia, PA 19115
Phone (215) 667-0667

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1538416748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-4600",
            "fax_number": "215-707-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182594",
            "telephone_number": "404-367-3350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19140",
            "country_code": "US",
            "telephone_number": "215-707-4600",
            "fax_number": "215-707-4034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN305661",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.