Individual provider Active NPI

Amber Stephany, PA

  • Physician Assistant
  • Thomasville, GA
National Provider Identifier
1619425675
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8279 Issued in GA
Practice address
401 Old Albany Rd
Thomasville, GA 31792-4014
Phone
(229) 228-8100
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109806 FL
Physician Assistant 363A00000X 8279 GA Primary

Addresses

Primary practice location

401 Old Albany Rd
Thomasville, GA 31792-4014

Mailing address

3122 Greenfield Cir
Jacksonville, FL 32216-5602
Phone (229) 977-0469

Other practice location 1

3122 Greenfield Cir
Jacksonville, FL 32216-5602
Phone (229) 977-0469

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
I20170221001424 GA Practitioner - Physician Assistant 6406130327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 Old Albany Rd
Thomasville, GA 31792-4014
Phone (229) 228-8115

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008279GAMDPediatrics Physician
PA9109806FLMDPhysician Assistant
8279GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
John D Archbold Memorial Hospital Inc CurrentSince Jul 1, 2021 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

401 Old Albany Rd
Thomasville, GA 31792
Phone (229) 228-8100

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

Interoperability endpoints

  • Direct secure messaging: amber.seago.1@15318.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1619425675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 GREENFIELD CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165602",
            "telephone_number": "229-977-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLD ALBANY RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924014",
            "telephone_number": "229-228-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3122 Greenfield Cir",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322165602",
            "country_code": "US",
            "telephone_number": "229-977-0469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHANY",
        "first_name": "AMBER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109806",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.