Individual provider Active NPI

Kristen Prather Stovall, MD

  • Family Medicine Physician
  • Clayton, GA
National Provider Identifier
1851093405
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
112604 Issued in GA
Practice address
811 Highway 441 N Ste 100
Clayton, GA 30525-6446
Phone
(706) 782-5991
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 112604 GA Primary

Addresses

Primary practice location

811 Highway 441 N Ste 100
Clayton, GA 30525-6446

Mailing address

1107 E 66TH St
Savannah, GA 31404-5701
Phone (912) 350-8404

Other practice location 1

1107 E 66th St
Savannah, GA 31404-5701
Phone (912) 350-8404

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
I20230801000192 GA Order and Referring Only - Family PracticePractitioner - Family Practice 9537520036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15043GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medlink Georgia Inc Past Accepting new patients
Medlink Georgia Inc PastSince May 4, 2026 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1851093405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E 66TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045701",
            "telephone_number": "912-350-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HIGHWAY 441 N STE 100",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305256446",
            "telephone_number": "706-782-5991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 E 66th St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314045701",
            "country_code": "US",
            "telephone_number": "912-350-8404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "KRISTEN",
        "middle_name": "PRATHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "112604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, GA

Sources for this page

Verify at the official NPI Registry.