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NPI 1417844853ActiveOrganization· Physician Assistant· Alpharetta, GA
Physician Assistant in Alpharetta, Georgia, registered in NPPES in June 2025. The authorized official on file is Jade Kalyn Stevens, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417844853 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 19, 2025 |
| Last updated in NPPES | Jun 19, 2025 |
| Certified by provider | Jun 19, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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