NPIMap

Individual provider Active NPI

Stephanie Lafontaine, M.D.

  • Gastroenterology Physician
  • Austell, GA
National Provider Identifier
1861453854
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
053475 Issued in GA
Practice address
3825 Medical Park Dr Ste 100
Austell, GA 30106-6831
Phone
(470) 267-1760
Fax
(470) 986-7002
NPI assigned
Mar 29, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 053475 GA Primary

Addresses

Primary practice location

3825 Medical Park Dr Ste 100
Austell, GA 30106-6831

Mailing address

3825 Medical Park Dr Ste 100
Austell, GA 30106-6831
Phone (470) 267-1760

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slafontainepatnett488509@directwellstar.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000030 GA Practitioner - GastroenterologyPractitioner - Internal Medicine 5395860316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3825 Medical Park Dr
Austell, GA 30106-6831

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

4441 Atlanta Rd SE
Suite 204
Smyrna, GA 30080-6442
Phone (470) 610-0145

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy106
Upper gastrointestinal (GI) endoscopy for acid reflux51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053475GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 15, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Izsak & Lamport,MD,PA Gastroenterology PastSince Jul 1, 1995 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Dalton Cardiology, P.C. Past Accepting new patients

Locations

3825 Medical Park Dr
Ste 100
Austell, GA 30106
Phone (470) 267-1760

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

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 5

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1861453854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR STE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066831",
            "telephone_number": "470-267-1760",
            "fax_number": "470-986-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR STE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066831",
            "telephone_number": "470-267-1760",
            "fax_number": "470-986-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFONTAINE",
        "first_name": "STEPHANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "053475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slafontainepatnett488509@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3825 Medical Park Dr Ste 100",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301066831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.