Stephanie Delphine Parris, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004454 Issued in GA

Practice address

2603 Osborne Rd Ste E
Saint Marys, GA 31558-8907

Phone

(770) 627-2675

NPI assigned

Apr 17, 2007

Last updated

Nov 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1912123183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 PEMBRIDGE TRCE NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301525471",
            "telephone_number": "770-627-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 OSBORNE RD STE E",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315588907",
            "telephone_number": "770-627-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRIS",
        "first_name": "STEPHANIE",
        "middle_name": "DELPHINE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICEN",
            "identifier": "004454",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• P L Hooton DMD PC (Camden Dental Care)
• Lauren J Panzarella, D.C.
• Livio Federico Pardi, MD
• Jennifer Parham, RN
• Edward Sidney Parker Jr., DMD
• Pauline L. Jacinto MD
• Allison Penney
• Savana Lynn Perez, RBT
• Annette O. Perry, LPC, NCC
• Michelle Yvonne Perry, M.D.

• Physician Assistant in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.