Individual provider Active NPI

Samantha Stoddard

  • Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1811938111
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN102555 Issued in GA
Practice address
1240 Eagles Landing Pkwy Ste 280
Stockbridge, GA 30281-5173
Phone
(770) 507-5055
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN102555 GA Primary

Addresses

Primary practice location

1240 Eagles Landing Pkwy Ste 280
Stockbridge, GA 30281-5173

Mailing address

2727 Paces Ferry Rd SE Ste 1-100
Atlanta, GA 30339-6150
Phone (470) 271-3418

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
I20040109000864 GA Practitioner - Nurse Practitioner 6103726898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1240 Eagles Landing Pkwy
Suite 280
Stockbridge, GA 30281-5173
Phone (770) 507-5055

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN102555GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Apr 22, 2019 Accepting new patients
NSH Cancer Institute Professional Services a LLC CurrentSince Feb 26, 2013 Accepting new patients
NSH Cancer Institute Professional Services a LLC CurrentSince Feb 26, 2013 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

2727 Paces Ferry Rd SE
Ste 1-100
Atlanta, GA 30339
Phone (404) 695-2980

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

1498 Klondike Rd SW
Ste 106
Conyers, GA 30094
Phone (770) 761-7260

2675 N Decatur Rd
Ste 200
Decatur, GA 30033
Phone (404) 296-1256

1240 Eagles Landing Pkwy
Ste 280
Stockbridge, GA 30281
Phone (770) 507-5055

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1811938111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY RD SE STE 1-100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396150",
            "telephone_number": "470-271-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 280",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-507-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN102555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.