Individual provider Active NPI

Judith Stallings, PA

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1750492260
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002199 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-4588
Fax
(706) 721-7264
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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 002199 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1499 Walton Way
Ste 1400
Augusta, GA 30901-2602
Phone (706) 724-6100

Other identifiers 2

IdentifierTypeStateIssuer
0144PAMedicaidSC
100000488AMedicaidGA

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
I20100309000557 GA Practitioner - Physician Assistant 9032254446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2799GAMDClinical Psychologist
002199GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Feb 23, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 23, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Augusta University Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

997 Saint Sebastian Way
Augusta, GA 30912
Phone (706) 721-3141

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1750492260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WALTON WAY",
            "address_2": "STE 1400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012602",
            "telephone_number": "706-724-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-4588",
            "fax_number": "706-721-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "JUDITH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000488A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.