Cory M Stanley, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116822 Issued in FL

Practice address

3245 Peachtree Pkwy # D188
Suwanee, GA 30024-6054

Phone

(888) 353-6843

Fax

(912) 303-7167

NPI assigned

Mar 30, 2007

Last updated

May 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care by PhoneGroup PAC ID 1456889922, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care by Phone

  dba Urgent Care of Jupiter Farms

  • Urgent Care Clinic/Center
  • Jupiter, FL
  • NPI 1669254728
  Medicare reassignment Care Compare group Authorized official
• Urgent Care of Berwick LLC

  dba Urgent Care of Berwick

  • Urgent Care Clinic/Center
  • Savannah, GA
  • NPI 1083018485
  Medicare reassignment Authorized official
• Skidaway Medical Group LLC

  dba Primary Care Savannah

  • Primary Care Clinic/Center
  • Savannah, GA
  • NPI 1164188413
  Medicare reassignment
• MD Now Medical Centers Inc

  • Urgent Care Clinic/Center
  • West Palm Beach, FL
  • NPI 1033195474
  NPD
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• Memorial Health Urgentone, Inc.

  dba UrgentOne Savannah Mall

  • Emergency Medicine Physician
  • Savannah, GA
  • NPI 1801818844

  Physician Assistant

  NPD (past)
• Skidaway Medical Group LLC

  dba Primary Care Wilmington Island

  • Primary Care Clinic/Center
  • Savannah, GA
  • NPI 1982360236
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090
  Care Compare affiliation

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1992825152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 LAKESHORE DR",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334588390",
            "telephone_number": "828-275-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 PEACHTREE PKWY # D188",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246054",
            "telephone_number": "888-353-6843",
            "fax_number": "912-303-7167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9060 N Military Trl",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334105972",
            "country_code": "US",
            "telephone_number": "561-295-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "CORY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01166",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005034",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567447065",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567447065B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567447065D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567447065A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP ID FOR URGENTONE",
            "identifier": "GPA892",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01061992",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID FOR URGENTONE",
            "identifier": "511I970040",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ID FOR URGENTONE",
            "identifier": "P00441750",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ID FOR URGENTONE",
            "identifier": "0580PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ID FOR URGENTONE",
            "identifier": "567447065E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ID FOR URGENTONE",
            "identifier": "567447065F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567447065C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP ID FOR URGENTONE",
            "identifier": "GPA9002",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Springhill Medical LLC
• Sprout Pediatric Dentistry LLC (Sprout Pediatric Dentistry)
• Sreedevi Vayalapalli, MD,PC (Care Psychiatry)
• St Joseph's Pediatrics LLC
• Shanon Lee St. Germain, LMT
• Laura Kay Stanley, L.P.C.
• Melissa Ann Stanley, MS, LAPC, NCC
• Nicola Gearing Stann, P.T.
• Valerie Kay Staples
• Brennan Anthony James Stapleton, DC

• Physician Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.