Individual provider Active NPI

Stacey Ann Parker, MD

  • Family Medicine Physician
  • Acworth, GA
National Provider Identifier
1891965281
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
060022 Issued in GA
Practice address
4791 S Main St
Acworth, GA 30101-5324
Phone
(770) 422-1400
Fax
(678) 290-6728
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 060022 GA Primary

Addresses

Primary practice location

4791 S Main St
Acworth, GA 30101-5324

Mailing address

4791 S Main St
Acworth, GA 30101-5324
Phone (770) 422-1400

Other identifiers 2

IdentifierTypeStateIssuer
060022OtherGALICENSE
120103132AMedicaidGA

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
I20080623000082 GA Practitioner - Family Practice 3971674730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1650 Chattahoochee Dr
Rockmart, GA 30153-2023
Phone (770) 684-7846

Hospital & facility affiliations

  • Coosa Valley Home Health, an Amedisys Home health agency, Rome, GA, CCN 117041
  • Pruitthealth at Home - Rome Home health agency, Rome, GA, CCN 117148
  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054
  • Atrium Health Floyd Polk Medical Center Hospital, Cedartown, GA, CCN 111330
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060022GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Jan 1, 2024 Accepting new patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Sep 3, 2022 Accepting new patients

Locations

4791 S Main St
Acworth, GA 30101
Phone (770) 422-1400

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

1650 Chattahoochee Dr
Rockmart, GA 30153
Phone (770) 684-6100

48 Hills Creek Rd
Taylorsville, GA 30178
Phone (770) 684-8700

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1891965281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 S MAIN ST",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015324",
            "telephone_number": "770-422-1400",
            "fax_number": "678-290-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 S MAIN ST",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015324",
            "telephone_number": "770-422-1400",
            "fax_number": "678-290-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "060022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "060022",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120103132A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

Verify at the official NPI Registry.