Individual provider Active NPI

Lanissa Rae Stinehelfer, FNP-BC

  • Family Nurse Practitioner
  • Social Circle, GA
National Provider Identifier
1841571957
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN130632 Issued in GA
Practice address
761 N Cherokee Rd
Social Circle, GA 30025-4019
Phone
(770) 464-4434
NPI assigned
Sep 1, 2011
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN130632 GA Primary

Addresses

Primary practice location

761 N Cherokee Rd
Social Circle, GA 30025-4019

Mailing address

3850 Mount Carmel Church Rd
Monroe, GA 30655-5343
Phone (706) 621-3103

Other names 1

  • Lanissa Rae Summerour Former name

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
I20140519001615 GA Practitioner - Nurse Practitioner 0941423099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1360 Caduceus Way
Suite 103
Watkinsville, GA 30677-7300
Phone (877) 448-3627

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN130632GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC CurrentSince Dec 20, 2023 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Dec 20, 2023 Accepting new patients
Our Family Health Center Past Accepting new patients
Tri-County Clinic, Inc. Past Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

11800 Northfall Ln
Ste 1406
Alpharetta, GA 30009
Phone (678) 413-1360

1360 Caduceus Way
Ste 103
Watkinsville, GA 30677
Phone (706) 548-7373

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFIGAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1841571957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 MOUNT CARMEL CHURCH RD",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306555343",
            "telephone_number": "706-621-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 N CHEROKEE RD",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300254019",
            "telephone_number": "770-464-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINEHELFER",
        "first_name": "LANISSA",
        "middle_name": "RAE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN130632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANISSA",
            "last_name": "SUMMEROUR",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Social Circle, GA

Sources for this page

Verify at the official NPI Registry.