Stephanie Van Dine

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN275921 Issued in GA

Practice address

6070 Lakeside Commons Dr
Macon, GA 31210-5778

Phone

(478) 254-2644

NPI assigned

May 7, 2018

Last updated

May 7, 2018By 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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middle Georgia Heart and Vascular Center, LLCGroup PAC ID 7012183650, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Navicent Health Baldwin Hospital, Milledgeville, GA, CCN 110150
• Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
• Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164

Merit-based Incentive Payment System (MIPS)

Final score

92.98 of 100Reported as individual

Quality

85.06

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CFAGBA
• Direct secure messaging: stephanie.vandine@mghvc.eclinicaldirectplus.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.

• Middle Georgia Heart and Vascular Center, LLC

  • Cardiovascular Disease Physician
  • Macon, GA
  • NPI 1205113057
  Medicare reassignment Care Compare group NPD

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

• Coliseum Medical Center, LLC

  dba Piedmont Macon Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1598719643
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Perry

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Warner Robins

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation
• Navicent Health Baldwin, Inc

  dba Atrium Health Navicent Baldwin

  • General Acute Care Hospital
  • Milledgeville, GA
  • NPI 1841701562
  Care Compare affiliation
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  Care Compare affiliation

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1588153498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 HIGH POINT RD NW",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310617068",
            "telephone_number": "256-310-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 LAKESIDE COMMONS DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105778",
            "telephone_number": "478-254-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DINE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN275921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravinder Reddy Valadri, MD
• Enrique Valencia, NP
• Jaime A Valencia, DMD
• Emily Valero, NP
• Sandra Valle, FNP
• Gennifer Leigh Van Pelt, LPC
• Luther Vance Jr., MD
• Christina Michelle Vandalinda, NP
• Kenwana Michelle Vanderbilt, PSY.D.
• Aurelia Vanderburg

• Family Nurse Practitioner in Macon, GA
• Providers in Macon, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.