Individual provider Active NPI

John Martin Stafford, A.A.

  • Anesthesiologist Assistant
  • Saint Louis, MO
National Provider Identifier
1942852785
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
9543 Issued in GA
Practice address
615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221
Phone
(314) 251-6000
Fax
(636) 386-7679
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 9543 GA Primary

Addresses

Primary practice location

615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221

Mailing address

339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191217002229 GA Practitioner - Anesthesiology Assistant 3678907052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Specialists in Anesthesia, P.C.Group PAC ID 9830170059, 112 clinicians

Practice addresses (Care Compare)

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (404) 257-1415

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Specialists in Anesthesia, P.C. Anesthesiologist Assistant CurrentSince Nov 1, 2019 Accepting new patients

Locations

5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001

5671 Ptree Dunwoody Rd NE
Ste 800
Sandy Springs, GA 30342
Phone (404) 257-1415

Organizations & group practices 1

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 2

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1942852785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD DEPT OF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000",
            "fax_number": "636-386-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "A.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "9543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.