Individual provider Active NPI

Stephanie Alexandra Beavers, MD

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1831457274
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75743 Issued in GA
Practice address
250 Martin Luther King Jr Blvd
Macon, GA 31201
Phone
(478) 301-2362
NPI assigned
Apr 23, 2012
Last updated
Jan 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 75743 GA Primary

Addresses

Primary practice location

250 Martin Luther King Jr Blvd
Macon, GA 31201

Mailing address

250 Martin Luther King Jr Blvd
Macon, GA 31201
Phone (478) 301-2362

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825000073 GA Practitioner - Internal Medicine 1951618842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Apr 30, 2024 Accepting new patients
The Corporation of Mercer University Internal Medicine CurrentSince Jan 9, 2019 Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Apr 30, 2024 Accepting new patients
The Corporation of Mercer University CurrentSince Jan 9, 2019 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1550 College St
Macon, GA 31207
Phone (478) 301-2600

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

764 Pine St
Macon, GA 31201
Phone (478) 633-1056

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1831457274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-301-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-301-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "STEPHANIE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "75743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.