Individual provider Active NPI

Debra Ann Stover, NP-C

  • Family Nurse Practitioner
  • Lithonia, GA
National Provider Identifier
1679076525
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN181848 Issued in GA
Practice address
1350 Swift Creek CT
Lithonia, GA 30058-3005
Phone
(678) 428-4070
NPI assigned
Mar 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN181848 GA Primary

Addresses

Primary practice location

1350 Swift Creek CT
Lithonia, GA 30058-3005

Mailing address

1350 Swift Creek CT
Lithonia, GA 30058-6054
Phone (678) 428-4070

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
I20200229000199 GA Practitioner - Nurse Practitioner 9133556269

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11301 W Olympic Blvd
Suite 121 PMB 662
Los Angeles, CA 90064-1615

1350 Swift Creek CT
Lithonia, GA 30058-3005

2620 Elm Hill Pike
Nashville, TN 37214-3108

275 Carpenter Dr
Suite 310
Atlanta, GA 30328-4909

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rmi Healthcare LLC CurrentSince Jan 14, 2024 Accepting new patients
TLC of Georgia LLC Family CurrentSince Jan 17, 2020 Accepting new patients
Centerwell Senior Primary Care Ga PC CurrentSince Jan 27, 2023 Accepting new patients
Centerwell Senior Primary Care Ga PC CurrentSince Jan 27, 2023 Accepting new patients

Locations

800 Glenwood Ave SE
Atlanta, GA 30316
Phone (470) 447-5031

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

1821 Mount Zion Rd
Morrow, GA 30260
Phone (470) 754-6380

6085 Old National Hwy
Ste G
South Fulton, GA 30349
Phone (470) 754-6360

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: debra.stover.1@29601.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1679076525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SWIFT CREEK CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586054",
            "telephone_number": "678-428-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SWIFT CREEK CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583005",
            "telephone_number": "678-428-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN181848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.