Stacy Reynolds

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

058917 Issued in GA

Practice address

1458 Church St Ste B
Decatur, GA 30030-1672

Phone

(404) 508-2000

Fax

(404) 508-5012

NPI assigned

Sep 20, 2007

Last updated

Oct 17, 2020By 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 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacy.reynolds@gadirect.net

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.

• Obhg Georgia, P.C.

  • Obstetrics & Gynecology Physician
  • Athens, GA
  • NPI 1750686838
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Dekalb Medical Center, Inc.

  dba Emory Decatur Hospital

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Dekalb Women's Specialists

  • Obstetrics & Gynecology Physician
  • Lithonia, GA
  • NPI 1275845893
  NPD (past)
• Dekalb Women's Specialists

  • Obstetrics & Gynecology Physician
  • Stone Mountain, GA
  • NPI 1851604995
  NPD (past)
• Dekalb Women's Specialists 2 LLC

  • Obstetrics & Gynecology Physician
  • Decatur, GA
  • NPI 1366572067
  NPD (past)
• West Georgia Medical Center, Inc.

  dba WellStar West Georgia Medical Center

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602892800000",
    "number": "1699961870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 WALLACE RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317758",
            "telephone_number": "404-405-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 CHURCH ST STE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301672",
            "telephone_number": "404-508-2000",
            "fax_number": "404-508-5012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8052 Mall Pkwy Ste 202",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300382649",
            "country_code": "US",
            "telephone_number": "404-508-2000",
            "fax_number": "404-377-0550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5295 Stone Mountain Hwy Ste N",
            "address_purpose": "LOCATION",
            "city": "Stone Mountain",
            "state": "GA",
            "postal_code": "300873439",
            "country_code": "US",
            "telephone_number": "404-508-2000",
            "fax_number": "404-377-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2020-10-17",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "058917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis Freddy Reyes, RN
• Silvio Reyes, LPC
• Aqyana Ryadh Reynolds
• Briana Reynolds, LCSW
• Nicholas Reynolds
• Rhea Gordon PHD LLC
• Elizabeth Rhea, LCSW, LICSW
• Travis Rhea, DPT
• Anderia Shirrell Rhodes-Bigham, N.P.
• Maria Ja Ribeiro, MD

• Obstetrics & Gynecology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.