Individual provider Active NPI

Stephanie Regine Garba

  • Family Nurse Practitioner
  • Alpharetta, GA
National Provider Identifier
1548869506
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
217090 Issued in GA
Practice address
401 S Main St Ste C7
Alpharetta, GA 30009-7960
Phone
(678) 319-9901
Fax
(678) 319-9902
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 217090 GA Primary

Addresses

Primary practice location

401 S Main St Ste C7
Alpharetta, GA 30009-7960

Mailing address

401 S Main St Ste C7
Alpharetta, GA 30009-7960
Phone (678) 319-9901

Other names 1

  • Stephanie Regine Green Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Alpharetta Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
217090GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Internal Medicine, LLC CurrentSince Dec 21, 2021 Accepting new patients

Locations

401 S Main St
Ste C7
Alpharetta, GA 30009
Phone (678) 319-9901

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDADCD/Endpoint/BDADCD

Organizations & group practices 1

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1548869506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST STE C7",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300097960",
            "telephone_number": "678-319-9901",
            "fax_number": "678-319-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST STE C7",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300097960",
            "telephone_number": "678-319-9901",
            "fax_number": "678-319-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBA",
        "first_name": "STEPHANIE",
        "middle_name": "REGINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "217090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Alpharetta",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "401 S Main St Ste C7",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300097960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "GREEN",
            "middle_name": "REGINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.