Mandy C Stout, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003919 Issued in GA

Practice address

1700 Tree LN
Suite 170
Snellville, GA 30078-6782

Phone

(770) 962-0399

Fax

(678) 252-3722

NPI assigned

Jan 26, 2007

Last updated

Mar 21, 2008By 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

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

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside CV Professional Services LLCGroup PAC ID 4880003771, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

76.66 of 100Reported as group

Quality

58.46

Promoting interoperability

83

Improvement activities

40

Cost

77.92

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Northside CV Professional Services LLC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1821612938
  Medicare reassignment Care Compare group
• Northside Cardiovascular Professional Services, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1518979921
  Medicare reassignment
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD
• Cardiovascular Group, PC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1215980479
  NPD (past)
• Gwinnett Heart Specialists LLC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1679818991
  NPD (past)
• SMG-Occupational Health Clinic

  • Primary Care Clinic/Center
  • Reidsville, GA
  • NPI 1710678925
  NPD (past)

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

• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1578619219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458725",
            "telephone_number": "770-962-0399",
            "fax_number": "678-252-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LN",
            "address_2": "SUITE 170",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-962-0399",
            "fax_number": "678-252-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "MANDY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Taylor Stone, NP-C
• Robert J Storms, CP
• Day la Story, RBT
• Str8Fwd Transportation LLC
• Straight Shot Mobile LLC
• Margaret J Strieper, D.O.
• Michelle Amanda Stringfield, R.T.(R)
• Xeroncia Hucks Stripling, NP/APRN

• Medical Physician Assistant in Snellville, GA
• Providers in Snellville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.