Individual provider Active NPI

Stacia N Shea, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1548397243
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005298 Issued in GA
Practice address
1100 Johnson Ferry Rd
Suite 600
Atlanta, GA 30342-1709
Phone
(404) 256-4777
Fax
(404) 256-5515
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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 005298 GA Primary

Addresses

Primary practice location

1100 Johnson Ferry Rd
Suite 600
Atlanta, GA 30342-1709

Mailing address

1835 Savoy Dr
Suite 300
Atlanta, GA 30341-1072
Phone (678) 288-9555

Other identifiers 1

IdentifierTypeStateIssuer
558666655IMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stacia.shea.p1@direct.gacancer.nextgenshare.com Direct

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
I20080717000265 GA Practitioner - Physician Assistant 8628004199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1045 Southcrest Dr
Suite 200
Stockbridge, GA 30281-6113
Phone (678) 289-0549

1100 Johnson Ferry Rd
Suite 600
Sandy Springs, GA 30342-1739
Phone (404) 256-4777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G LLC CurrentSince Oct 10, 2016 Accepting new patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Oct 10, 2016 Accepting new patients
Northside Imaging LLC Past Accepting new patients
Mark T Howell DO PA PastSince Jun 26, 2012 Accepting new patients

Locations

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

1100 Johnson Fy Rd NE
Ste 600
Sandy Springs, GA 30342
Phone (404) 256-4777

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

Interoperability endpoints

  • Direct secure messaging: stacia.shea.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 5

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.

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1548397243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "678-288-9555",
            "fax_number": "678-288-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD",
            "address_2": "SUITE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "STACIA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558666655I",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacia.shea.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1100 Johnson Ferry Rd",
            "address_2": "Suite 600",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.