STACEY FAVRE RENNER (APRN) – Family Nurse Practitioner, NPI 1043633985
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for STACEY FAVRE RENNER (APRN)
4300 N POINT PKWY STE 300
ALPHARETTA, GA 300224102
Phone:
Type: Mailing
127 OLD HIGHWAY 96 STE B
BONAIRE, GA 310053461
Phone: (478) 352-7143
Fax: (478) 352-7144
Type: Location
140 OSIGIAN BLVD
BLDG #300
WARNER ROBINS, GA 310888029
Phone: (478) 329-0291
Fax: (478) 333-3609
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 98 Open Payments records for all available years, with a total value of $2,269.
Total Amount is formed as General ($2,269) + Research ($0) + Ownership ($0) = $2,269.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Novo Nordisk Inc ($449).
Total Amount
$2,269
General + Research + Ownership
Payments
98
Total payment records
General Amount
$2,269
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-05-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140520002634 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30022)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| Diagnostic Radiology | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | GA | |
| Internal Medicine, Allergy/Immunology | GA | |
| General Practice | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | GA |
Reviews
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