Individual provider Active NPI

Sydney Stoneback

  • Student in an Organized Health Care Education/Training Program
  • Tallahassee, FL
National Provider Identifier
1669203808
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1115 W Call St
Tallahassee, FL 32304-3556
Phone
(850) 644-1855
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1115 W Call St
Tallahassee, FL 32304-3556

Mailing address

1115 W Call St
Tallahassee, FL 32304-3556
Phone (850) 644-1855

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
I20250227002222 GA Practitioner - Physician Assistant 7517487010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1155 Concord Rd SE
Suite 200
Smyrna, GA 30080-4255
Phone (678) 600-5137

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2520 N Decatur Rd
Decatur, GA 30033-6117
Phone (678) 685-8100

2700 Clairmont Rd NE
Atlanta, GA 30329-2713
Phone (404) 327-1747

3617 Roswell Nerd a
Atlanta, GA 30305-1111
Phone (404) 996-0196

4475 W Village Pkwy
Ellenwood, GA 30294-2869
Phone (770) 507-7950

4650 Hugh Howell Rd
Suite 500
Tucker, GA 30084-5003
Phone (678) 956-8630

882 Ponce de Leon Ave
Atlanta, GA 30306-4268
Phone (770) 809-3034

976 Killian Hill Rd SW
Suite a
Lilburn, GA 30047-3102
Phone (770) 751-4142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12866GAMDInternal Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1669203808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W CALL ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323043556",
            "telephone_number": "850-644-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CALL ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323043556",
            "telephone_number": "850-644-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONEBACK",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.