Individual provider Active NPI

Sydney Elise Caudell, NP-C

  • Family Nurse Practitioner
  • Toccoa, GA
National Provider Identifier
1558091827
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN283320 Issued in GA
Practice address
115 Rock Quarry Rd
Toccoa, GA 30577-8734
Phone
(706) 282-5815
NPI assigned
Jun 10, 2022
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 RN283320 GA Primary

Addresses

Primary practice location

115 Rock Quarry Rd
Toccoa, GA 30577-8734

Mailing address

102 Norton Rd
Eastanollee, GA 30538-3002
Phone (706) 244-2660

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
I20220825000536 GA Practitioner - Nurse Practitioner 3375927304 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN283320GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens County Hospital Physician Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Stephens County Hospital Physician Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Stephens County Hospital Physician Group LLC Current Accepting new patients
Stephens County Hospital Physician Group, LLC Past Accepting new patients

Locations

115 Rock Quarry Rd
Toccoa, GA 30577
Phone (706) 282-5815

Interoperability endpoints

  • Direct secure messaging: sydney.caudell.1@14936.direct.athenahealth.com

Organizations & group practices 4

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1558091827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NORTON RD",
            "city": "EASTANOLLEE",
            "state": "GA",
            "postal_code": "305383002",
            "telephone_number": "706-244-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCK QUARRY RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305778734",
            "telephone_number": "706-282-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDELL",
        "first_name": "SYDNEY",
        "middle_name": "ELISE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN283320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

Verify at the official NPI Registry.