Kelley A. Stahl, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

054257 Issued in GA

Practice address

407 E Maple St
Suite 101
Cumming, GA 30040-2635

Phone

(770) 888-6697

Fax

(770) 888-6998

NPI assigned

Nov 16, 2005

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelley.stahl@108578894446596.direct.elationemr.com

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.

• Wellstar Physicians Group Hospitalists, LLC

  dba WellStar Physicians Group Kennestone Hospitalists, LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1629025754
  NPD (past)
• Boston Heart Diagnostics Corporation

  • Clinical Medical Laboratory
  • Lenexa, KS
  • NPI 1922259753
  NPD (past)
• Greenville Health System

  dba GHS Cardiovascular SVCS Simp

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD (past)
• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1760464549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E MAPLE ST",
            "address_2": "SUITE 101",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402635",
            "telephone_number": "770-888-6697",
            "fax_number": "770-888-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E MAPLE ST",
            "address_2": "SUITE 101",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402635",
            "telephone_number": "770-888-6697",
            "fax_number": "770-888-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "KELLEY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spotlight Family Dental LLC (Spotlight Dental)
• Sprout Therapy
• Square One Dental LLC
• Shruti Srihari
• Jarod Stackpole
• Tina R Stamey, CD (DONA)
• Audiya Stanley, BCBA
• Brigette Leigh Stanley
• David D Stanley, PT, DPT
• Kira Tifanie Stapleton

• Internal Medicine Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.