Individual provider Active NPI

Stefanie Solomon, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1689001315
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone
(919) 391-7202
NPI assigned
Sep 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102

Mailing address

4895 Lake Fjord Pass
Marietta, GA 30068
Phone (561) 289-9905

Other practice location 1

510 Clinton Sq Ofc 509
Rochester, NY 14604-1700
Phone (919) 391-7202

Other practice location 2

1055 Howell Mill Rd NW Fl 8
Atlanta, GA 30318-5557
Phone (919) 391-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220503000948 GA Practitioner - Physician Assistant 0941572341 Reassigns benefits to 2 organizations
I20230324002267 NC Practitioner - Physician Assistant 0941572341 Reassigns benefits to 1 organization
I20250519000707 NY Practitioner - Physician Assistant 0941572341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Animo Sano Psychiatry PLLCGroup PAC ID 8729489182, 53 clinicians

Practice addresses (Care Compare)

45 S Ave SE
Suite 5
Marietta, GA 30060-2538
Phone (919) 391-7202

5501 Fortunes Ridge Dr
Suite P
Durham, NC 27713-6102
Phone (919) 391-7202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024721NYMDClinical Psychologist

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.

NPI Registry JSON

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1689001315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 LAKE FJORD PASS",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "561-289-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Clinton Sq Ofc 509",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146041700",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 Howell Mill Rd NW Fl 8",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303185557",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "STEFANIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.