Stephanie Tara Stancel, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN169676 Issued in GA

Practice address

3815 Harrison Rd
Loganville, GA 30052-2462

Phone

(770) 466-6112

NPI assigned

Jun 30, 2010

Last updated

Mar 4, 2014By 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 2

Addresses

Other names 1

• Stephanie Tara Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

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.

• Loganville Pediatrics & Adolescent Care Associates

  • Pediatric Adolescent Medicine Physician
  • Loganville, GA
  • NPI 1053325027
  NPD (past)

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1699086025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LAUREL CROSSING PKWY",
            "address_2": "APARTMENT 202",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305196562",
            "telephone_number": "770-364-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 HARRISON RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522462",
            "telephone_number": "770-466-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCEL",
        "first_name": "STEPHANIE",
        "middle_name": "TARA",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN169676",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN169676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WILSON",
            "middle_name": "TARA",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Spectrum Early Intervention Center LLC
• Susan Fleming Spissman, LPC
• SRG Inc (Sportaid/Medaid)
• Alicia St Vincent
• Courtney Stallworth, BSN RN IBCLC
• Kimberly Stanton, RN
• Alyssa Hope Stewart, MS
• Amanda Kleweno Stewart, PT
• Lashauna Stewart
• Stillwell Medical Group

• Pediatric Nurse Practitioner in Loganville, GA
• Providers in Loganville, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.