Individual provider Active NPI

Stephen B Routt, PA-C

  • Physician Assistant
  • Morrow, GA
National Provider Identifier
1912023953
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000750 Issued in GA
Practice address
1368 Southlake Professional Place
Morrow, GA 30260
Phone
(615) 778-4066
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000750 GA Primary

Addresses

Primary practice location

1368 Southlake Professional Place
Morrow, GA 30260

Mailing address

5080 Spectrum Drive
Suite 1200 West Tower
Addison, TX 75001
Phone (800) 232-3550

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
I20080225000122 GA Practitioner - Physician Assistant 0446334841 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000750GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Dec 12, 2011 Accepting new patients
Health Choice Urgent Care, LLC CurrentSince Nov 13, 2016 Accepting new patients
Health Choice Urgent Care, LLC CurrentSince Nov 13, 2016 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2690 Hamilton Mill Rd
Ste 100
Buford, GA 30519
Phone (470) 326-7300

1400 Front Ave
Ste 300
Lutherville Timonium, MD 21093

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1912023953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DRIVE",
            "address_2": "SUITE 1200 WEST TOWER",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "75001",
            "telephone_number": "800-232-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 SOUTHLAKE PROFESSIONAL PLACE",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "30260",
            "telephone_number": "615-778-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTT",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "000750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.