Individual provider Active NPI

Karen V Stabler, P.A.

  • Physician Assistant
  • Gainesville, GA
National Provider Identifier
1912903618
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501-3861
Phone
(770) 536-9864
Fax
(770) 297-5011
NPI assigned
Jun 27, 2005
Last updated
Aug 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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 Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501-3861

Mailing address

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone (770) 536-9864

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
I20041104000217 GA Practitioner - Physician Assistant 1153384854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003411GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1912903618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "STE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABLER",
        "first_name": "KAREN",
        "middle_name": "V",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.