Individual provider Active NPI

Stacy Marie Nobles, NP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1982339826
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN264228 Issued in GA
Practice address
3400 Riverside Dr
Macon, GA 31210-2513
Phone
(478) 474-5600
Fax
(478) 471-6769
NPI assigned
Jul 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN264228 GA Primary

Addresses

Primary practice location

3400 Riverside Dr
Macon, GA 31210-2513

Mailing address

3400 Riverside Dr
Macon, GA 31210-2513
Phone (478) 474-5600

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
I20221013002467 GA Practitioner - Nurse Practitioner 7719353986 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical Center of Central Georgia Inc.Group PAC ID 3678477445, 30 clinicians

Practice addresses (Care Compare)

3400 Riverside Dr
Macon, GA 31210-2513
Phone (478) 474-5600

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN264228GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Emergency Group, LLC CurrentSince Aug 25, 2022 Accepting new patients
The Medical Center of Central Georgia Inc CurrentSince Aug 18, 2022 Accepting new patients
Health Services of Central Georgia, Inc CurrentSince Oct 20, 2024 Accepting new patients
The Medical Center of Central Georgia Inc. Current Accepting new patients

Locations

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

3400 Riverside Dr
Macon, GA 31210
Phone (478) 474-5600

1339 Gray Hwy
Macon, GA 31211
Phone (205) 514-4665

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: smccrory474086@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 1

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": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1982339826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102513",
            "telephone_number": "478-474-5600",
            "fax_number": "478-471-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102513",
            "telephone_number": "478-474-5600",
            "fax_number": "478-471-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN264228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.