Stacey Lynn Pullen, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN174219 Issued in GA

Practice address

14 Cherokee Rd
Cedartown, GA 30125-4381

Phone

(770) 749-9600

Fax

(770) 749-9628

NPI assigned

Oct 4, 2012

Last updated

Apr 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacey Lynn Head Other name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

65.74

Promoting interoperability

100

Improvement activities

40

Cost

78.37

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spullen3004803@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: stacey.pullen.1@1498.direct.athenahealth.com
• Direct secure messaging: stacey.pullen.1@21043.direct.athenahealth.com

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.

• Harbin Clinic, LLC

  dba Harbin Clinic

  • Multi-Specialty Clinic/Center
  • Rome, GA
  • NPI 1679599088
  Medicare reassignment Care Compare group NPD
• Harbin Clinic, LLC

  dba Harbin GI

  • Ambulatory Surgical Clinic/Center
  • Rome, GA
  • NPI 1447385158
  NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1467016055
  NPD

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

• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Medical Center

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1154377166
  Care Compare affiliation

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1568714210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 CHEROKEE RD",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301254381",
            "telephone_number": "770-749-9600",
            "fax_number": "770-749-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN174219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003128807A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacey.pullen.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "14 Cherokee Rd",
            "city": "Cedartown",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301254381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "HEAD",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charity Prater
• Janet Prater
• Primary Health Care Center of Dade, Inc.
• Heather A. Pryor, M.D.
• Cathy Puckett
• Robert Clinton Pyle, MD
• Micaela Quesada
• Ray Popham OD
• Redmond ER Services, Inc
• Redmond Physician Practice Company (Redmond Family Care Center at Cedartown)

• Nurse Practitioner in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.