Individual provider Active NPI

Stanton A Stebbins, M.D.

  • Pediatrics Physician
  • Roswell, GA
National Provider Identifier
1770768541
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
062439 Issued in GA
Practice address
11050 Crabapple Road
Ste. 120
Roswell, GA 30075
Phone
(770) 518-9277
Fax
(770) 518-8718
NPI assigned
Dec 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 002116 GA
Pediatrics Physician 208000000X 062439 GA Primary

Addresses

Primary practice location

11050 Crabapple Road
Ste. 120
Roswell, GA 30075

Mailing address

11050 Crabapple Road
Ste. 120
Roswell, GA 30075
Phone (770) 518-9277

Other identifiers 2

IdentifierTypeStateIssuer
498346592BMedicaidGA
498346592AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002116GAMDPediatrics Physician
062439GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Snapfinger Woods Pediatric Associates P C Pediatrics Past Accepting new patients
Pediatric Physicians, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stanton.stebbins.1@14597.direct.athenahealth.com

Organizations & group practices 2

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": "1198886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1770768541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 CRABAPPLE ROAD",
            "address_2": "STE. 120",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30075",
            "telephone_number": "770-518-9277",
            "fax_number": "770-518-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 CRABAPPLE ROAD",
            "address_2": "STE. 120",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30075",
            "telephone_number": "770-518-9277",
            "fax_number": "770-518-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEBBINS",
        "first_name": "STANTON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-29",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "002116",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "062439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498346592B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498346592A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.