STACY T SULLENBERGER (NPI# 1023355484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023355484 |
| Entity Type | Individual |
| Full Name | STACY T SULLENBERGER |
| Credential | CNP |
| Practice Address |
662 N Main St Springboro OH 45066 |
| Mailing Address |
1 Childrens Plz Dayton OH 45404-1873 |
| Practice Telephone | 9376413000 |
| Mailing Telephone | 9376413000 |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
14148 NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0330291 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Childrens Plz, Dayton, OH 454041873 | 9376414000 | 9376414500 |
| 410 Valley St, Dayton, OH 454041843 | 9376414000 | 9376414500 |
| 320 E Silver St, Lebanon, OH 450361887 | 9376414000 | 9376414500 |
| 1483 W Main St, Tipp City, OH 453712803 | 9376678067 |
| Street Address |
662 N MAIN ST |
| City | SPRINGBORO |
| State | OH |
| Zip Code | 45066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205145745 | Nicole Garritano | Nurse Practitioner | 662 N Main St, Springboro, OH 45066-9553 | 2010-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609577 | Erica Lynn Ivey | Social Worker | 70 W. South St, Springboro, OH 45066 | 2020-11-02 |
| 1417515305 | Tapestry Springboro Senior Housing Management, LLC | Assisted Living Facility | 8683 Clearcreek Franklin Rd., Springboro, OH 45066 | 2019-06-05 |
| 1073081204 | Chelsea L Zastrow | Nurse Practitioner | 725 N. Main Street, Springboro, OH 45066 | 2018-11-06 |
| 1801378245 | Misty Woods | Nurse Practitioner | 540 W Central Ave., Springboro, OH 45066 | 2018-09-02 |
| 1154860815 | Infinity Chiropractic and Nutrition LLC | Chiropractor | 99 Edgebrooke Dr, Springboro, OH 45066 | 2017-02-14 |
| 1669898409 | Rebecca Miller | Physical Therapist | 195 Kesling Dr., Box 177, Springboro, OH 45066 | 2014-03-17 |
| 1124376157 | Motion Rehabilitation Center, LLC. | Occupational Therapist | 7917 Woodbridge Ct., Springboro, OH 45066 | 2012-08-23 |
| 1881827731 | Caroline Castleforte | Pediatrics | 8815 Glen Abbey Ct., Springboro, OH 45066 | 2009-08-26 |
| 1740453984 | Springboro Family Medicine Inc | Family Medicine | 5 Sycamore Creek Drive, Springboro, OH 45066 | 2008-04-09 |
| 1538389853 | Ohio Dental Professionals Workman, PC | Dentist | 780 North Main St, Springboro, OH 45066 | 2007-04-27 |
| Find all providers in zip 45066 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264675 | House Calls for Kids, LLC | Nurse Practitioner | 308 Taft St, Columbus Grove, OH 45830-1122 | 2020-10-28 |
| 1225637150 | Leesha Paulus | Nurse Practitioner | 7984 Windward Trace Cir Nw, Massillon, OH 44646-1176 | 2020-10-21 |
| 1861008948 | Amanda Marie Allmon | Nurse Practitioner | 5669 New Albany Rd W, New Albany, OH 43054-7589 | 2020-09-23 |
| 1568099182 | Megan Mackenzie Novak | Nurse Practitioner | 11820 Edgewater Dr Apt 106, Lakewood, OH 44107-1767 | 2020-03-24 |
| 1528613346 | Stacia N Boyer | Nurse Practitioner | 1611 27th Street, Fulton Bldg Suite 101, Portsmouth, OH 45662 | 2019-08-08 |
| 1639721905 | Lora Harris | Nurse Practitioner | 1029 S. Trimble Rd, Mansfield, OH 44906 | 2019-07-16 |
| 1720640089 | Marybeth Kathleen Hannum | Nurse Practitioner | 6076 Whipple Ave Nw, North Canton, OH 44720-7616 | 2019-07-07 |
| 1558832758 | Kisandra Leigh Sanders | Nurse Practitioner | 3500 Wild Cherry Ave, Celina, OH 45822-2747 | 2018-12-16 |
| 1851869598 | Whitney Stine | Nurse Practitioner | 410 W 10th Ave Fl 7, Columbus, OH 43210-1240 | 2018-11-12 |
| 1194291070 | Helena Horwitz | Nurse Practitioner | 7200 Poe Ave Ste 201, Dayton, OH 45414-2799 | 2018-10-18 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGBORO |
| Zip Code | 45066 |
Please comment or provide details below to improve the information on STACY T SULLENBERGER.
| 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.