Individual provider Active NPI

Brooke R Stubbs, P.A.

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1710969209
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004683 Issued in GA
Practice address
1326 Eisenhower Dr
BLDG. 2
Savannah, GA 31406-3928
Phone
(912) 527-5300
Fax
(912) 527-5154
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 004683 GA Primary

Addresses

Primary practice location

1326 Eisenhower Dr
BLDG. 2
Savannah, GA 31406-3928

Mailing address

1326 Eisenhower Dr
BLDG. 2
Savannah, GA 31406-3928
Phone (912) 527-5300

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
I20051025000852 GA Practitioner - Physician Assistant 2365469772 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004683GAMDPhysician Assistant

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710969209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 EISENHOWER DR",
            "address_2": "BLDG. 2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063928",
            "telephone_number": "912-527-5300",
            "fax_number": "912-527-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 EISENHOWER DR",
            "address_2": "BLDG. 2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063928",
            "telephone_number": "912-527-5300",
            "fax_number": "912-527-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "BROOKE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.