NPIMap

Organization Active NPI

Southern Crescent Womens Health Specialists at Eagle's Landing

Doing business as Women's Health Specialists

  • Specialist
  • Stockbridge, GA
National Provider Identifier
1952518698
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
105947 Issued in GA
Legal business name
SOUTHERN CRESCENT WOMENS HEALTH SPECIALISTS AT EAGLE'S LANDING
Doing business as
Women's Health Specialists
Practice address
1050 Eagles Landing Pkwy Ste 302
Stockbridge, GA 30281-9250
Phone
(770) 474-0064
Fax
(770) 474-2998
NPI assigned
May 16, 2007
Last updated
Aug 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Mrs. Lynn Stapleton
Title
Practice Administrator
Phone
(770) 474-0064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 105947 GA Primary

Addresses

Primary practice location

1050 Eagles Landing Pkwy Ste 302
Stockbridge, GA 30281-9250

Mailing address

1050 Eagles Landing Pkwy Ste 302
Stockbridge, GA 30281-9250
Phone (770) 474-0064

Other names 1

  • Women's Health Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518001464 GA Part B Supplier - Clinic/Group Practice 3072504240 Receives reassigned benefits from 6 practitioners
Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory
Tax ID family
Southern Crescent Women's Health Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 Eagle Spring Dr
Ste 200
Stockbridge, GA 30281
Phone (770) 474-0064

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1952518698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY STE 302",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819250",
            "telephone_number": "770-474-0064",
            "fax_number": "770-474-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY STE 302",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819250",
            "telephone_number": "770-474-0064",
            "fax_number": "770-474-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT WOMENS HEALTH SPECIALISTS AT EAGLE'S LANDING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "STAPLETON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-474-0064",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "105947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Health Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.