DR. ALAN J. STEVENSON (NPI# 1154413383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154413383 |
| Entity Type | Individual |
| Full Name | DR. ALAN J. STEVENSON |
| Credential | M.D. |
| Practice Address |
677 Church St Ne Marietta GA 30060-1101 |
| Practice Telephone | 7707935435 |
| Mailing Telephone | 7707935435 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
047665 | GA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
40220 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000841981H | 05 | |
| GA | AMERIGROUP GA MEDICAIDCMO | 10054286 | 01 |
| GA | WELLCARE GA MEDICAID CMO | 335783 | 01 |
| NC | 5902738 | 05 | |
| TN | TLC TENNCARE | 000000036657 | 01 |
| GA | 000841981G | 05 | |
| AL | 009934501 | 05 | |
| TN | 3334229 | 05 | |
| TN | UNISON TENNCARE | 173844 | 01 |
| KY | 64114622 | 05 | |
| TN | BLUE CROSS | 4115257 | 01 |
| TN | PHP TENNCARE | 100049673 | 01 |
| Street Address |
677 CHURCH ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285095 | Grace S Kim | Anesthesiology | 677 Church St Ne, Marietta, GA 30060-1101 | 2005-09-14 |
| 1205436425 | Lakesha Alexis | Nurse Practitioner | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-10-27 |
| 1710594080 | Terrence Helms | Nurse Anesthetist, Certified Registered | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-09-30 |
| 1063022481 | Laura Elliott | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-08-01 |
| 1346868908 | Megan Grace Zimmerman | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-07-10 |
| 1578180535 | Devon Potler-jack | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-06-25 |
| 1740802032 | Noelle Shaw | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-05-11 |
| 1316567860 | Molly O'keeffe | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-24 |
| 1740800317 | Sara Roberts | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| 1508486184 | Luke Bishop | Student in an Organized Health Care Education/Training Program | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487604849 | Judy H. Sequeira | Pathology | 488 Kennesaw Ave Nw, Suite 200, Marietta, GA 30060-9409 | 2006-05-10 |
| 1760444186 | Hany M Bishara | Pathology | 833 Campbell Hill St, Suite 111, Marietta, GA 30060 | 2006-04-03 |
| 1508090937 | Sara Acree | Pathology | 677 Church St Ne, Department of Pathology, Marietta, GA 30060-1101 | 2009-05-13 |
| 1164669388 | Tri County Pathology Associates Lab | Pathology | 833 Campbell Hill St Nw, Suite 111, Marietta, GA 30060-1134 | 2009-01-09 |
| 1356587109 | Matthew J Macatol Md | Pathology | 401 Matthew St, Marietta, OH 45750-1635 | 2008-12-29 |
| 1245412402 | Fortunato R Macatol | Pathology | 401 Matthew St, Marietta, OH 45750-1635 | 2007-11-29 |
| 1912199720 | Matthew J Macatol | Pathology | 401 Matthew St, Marietta, OH 45750-1635 | 2007-08-15 |
| 1336270875 | Aimee Popp | Pathology | 677 Church St Ne, Marietta, GA 30060-1101 | 2007-03-08 |
| 1073653655 | Burton Kim | Pathology | 677 Church St Ne, Marietta, GA 30060-1101 | 2007-02-06 |
| 1164560876 | Sara Elizabeth Nash | Pathology | 2275 Northwest Parkway Se, Suite 140, Marietta, GA 30067-9319 | 2007-02-02 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.