Stephanie Ruth Mezick

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

S14704 Issued in AL

Practice address

116 Bailey Rd
Lagrange, GA 30240-8201

Phone

(706) 416-9889

NPI assigned

Nov 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1992529622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BAILEY RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302408201",
            "telephone_number": "706-416-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BAILEY RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302408201",
            "telephone_number": "706-416-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZICK",
        "first_name": "STEPHANIE",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "PHI-023594",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "S14704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.