Active NPI
Stephen Beasley
- Gastroenterology Physician
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 84807
- Practice address
- 763 Old Norcross Rd
Lawrenceville, GA 30046-4317 - Phone
- (678) 985-2000
- NPI assigned
- Sep 8, 2013
- Last updated
- Jun 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 390200000X - | GA | |
| Gastroenterology Physician | 207RG0100X | 84807 | GA | Primary |
Addresses
Primary practice location
763 Old Norcross Rd
Lawrenceville, GA 30046-4317
Mailing address
763 Old Norcross Rd
Lawrenceville, GA 30046-4317
Phone (678) 985-2000
Other practice location 1
4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-1734
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.southern-gastro.com/lawrenceville-gastroenterology-office.php | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Mercer University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
763 Old Norcross Rd
Lawrenceville, GA 30046-4317
Phone (678) 985-2000
Hospital & facility affiliations
- Northside Hospital Gwinnett
- Northside Hospital Duluth
- Piedmont Eastside Medical Center
- Northside Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 82 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 63 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X - | GA | MD | Internal Medicine Physician |
| 84807 | GA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Gastroenterology Associates, LLC | Gastroenterology | Current | Accepting new patients |
| University of South Alabama | Current | Accepting new patients | |
| University of South Alabama | Internal Medicine | Current | Accepting new patients |
| University of South Alabama | Internal Medicine | Current | Accepting new patients |
Locations
1660 Spring Hill Ave
Mobile, AL 36604
Phone (251) 445-9616
1660 Spring Hill Ave
Ste 3069
Mobile, AL 36604
Phone (251) 445-8405
2451 University Hospital Dr
Mobile, AL 36617
Phone (251) 471-7000
75 S University Blvd
Ste 6000A
Mobile, AL 36608
Phone (251) 660-5787
763 Old Norcross Rd
Lawrenceville, GA 30046
Phone (678) 985-1994
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.
-
- Gastroenterology Physician
- Lawrenceville, GA
- NPI 1205886504
-
dba USA Student Health Center
- Family Medicine Physician
- Mobile, AL
- NPI 1992746838
Internal Medicine
-
- Clinical Medical Laboratory
- Mobile, AL
- NPI 1497859052
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Piedmont Eastside Medical Center
- General Acute Care Hospital
- Snellville, GA
- NPI 1467406132
-
dba Northside Hospital
- General Acute Care Hospital
- Atlanta, GA
- NPI 1457396079
-
dba Northside Hospital Duluth
- General Acute Care Hospital
- Duluth, GA
- NPI 1790715381
-
dba Northside Hospital Gwinnett
- General Acute Care Hospital
- Lawrenceville, GA
- NPI 1952340994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590969600000",
"number": "1568897668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "763 OLD NORCROSS RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464317",
"telephone_number": "678-985-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "763 OLD NORCROSS RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464317",
"telephone_number": "678-985-2000"
}
],
"practiceLocations": [
{
"address_1": "4700 Waters Ave",
"address_purpose": "LOCATION",
"city": "Savannah",
"state": "GA",
"postal_code": "314046220",
"country_code": "US",
"telephone_number": "912-350-1734",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEASLEY",
"first_name": "STEPHEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-08",
"last_updated": "2020-06-01",
"certification_date": "2020-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "390200000X -",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "GA",
"license": "84807",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.southern-gastro.com/lawrenceville-gastroenterology-office.php",
"affiliation": "N",
"endpointDescription": "website",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "website",
"address_1": "763 Old Norcross Rd",
"city": "Lawrenceville",
"state": "GA",
"country_code": "US",
"postal_code": "300464317",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.