Individual provider Active NPI

Christopher Adam Stanley, PA-C

  • Medical Physician Assistant
  • Lagrange, GA
National Provider Identifier
1881155182
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9297 Issued in GA
Practice address
1602 Vernon Rd Ste 300
Lagrange, GA 30240-4129
Phone
(706) 242-5100
NPI assigned
Mar 28, 2019
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 9297 GA Primary

Addresses

Primary practice location

1602 Vernon Rd Ste 300
Lagrange, GA 30240-4129

Mailing address

409 College Ave
Lagrange, GA 30240-3015
Phone (229) 938-3101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cstanley343387@directwellstar.org

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
I20190729003638 GA Practitioner - Physician Assistant 0547596538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
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)

1510 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3905

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 880-7222

1602 Vernon Rd
Lagrange, GA 30240-4129

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Single Specialty CurrentSince Jul 1, 2019 Accepting new patients
Wellstar Medical Group, LLC Single Specialty CurrentSince Jul 1, 2019 Accepting new patients

Locations

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

1602 Vernon Rd
Ste 300
Lagrange, GA 30240
Phone (706) 242-5100

Organizations & group practices 3

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1881155182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COLLEGE AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403015",
            "telephone_number": "229-938-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 VERNON RD STE 300",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404129",
            "telephone_number": "706-242-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstanley343387@directwellstar.org",
            "affiliation": "N",
            "address_1": "1602 Vernon Rd Ste 300",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.