Individual provider Active NPI

Meredith Staton, P.A.-C

  • Medical Physician Assistant
  • Lavonia, GA
National Provider Identifier
1841328101
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003412 Issued in GA
Practice address
355 Clear Creek Pkwy Ste 2007
Lavonia, GA 30553-4271
Phone
(706) 356-2934
Fax
(706) 356-8037
NPI assigned
Mar 1, 2007
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003412 GA Primary

Addresses

Primary practice location

355 Clear Creek Pkwy Ste 2007
Lavonia, GA 30553-4271

Mailing address

3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone (706) 353-2990

Other practice location 1

3320 Old Jefferson Rd Bldg 700
Athens, GA 30607-1465
Phone (706) 353-2990 ext. 225

Other practice location 2

1656 Falls Rd Ste B
Toccoa, GA 30577-2411
Phone (706) 886-0392

Other identifiers 1

IdentifierTypeStateIssuer
003412OtherGASTATE LISENCE

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
I20050321000287 GA Practitioner - Physician Assistant 8820043136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1656 Falls Rd
Suite B
Toccoa, GA 30577-2411
Phone (706) 886-0392

3320 Old Jefferson Rd
BLDG 700
Athens, GA 30607-1465
Phone (706) 353-2990

355 Clear Creek Pkwy
Suite 2007
Lavonia, GA 30553-4271
Phone (706) 356-2934

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3412GAMDCase Manager/Care Coordinator
003412GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Alliance Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1841328101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CLEAR CREEK PKWY STE 2007",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305534271",
            "telephone_number": "706-356-2934",
            "fax_number": "706-356-8037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990 x225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1656 Falls Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Toccoa",
            "state": "GA",
            "postal_code": "305772411",
            "country_code": "US",
            "telephone_number": "706-886-0392",
            "fax_number": "706-886-9204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATON",
        "first_name": "MEREDITH",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISENCE",
            "identifier": "003412",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lavonia, GA

Sources for this page

Verify at the official NPI Registry.