MRS. AMY J STACEY (NPI# 1063412468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063412468 |
| Entity Type | Individual |
| Full Name | MRS. AMY J STACEY |
| Credential | PA-C |
| Practice Address |
1300 N 4th St Longview TX 75601-4717 |
| Mailing Address |
Po Box 911230 Dallas TX 75390-1230 |
| Practice Telephone | 9037576042 |
| Practice Fax Number | 9037581801 |
| Mailing Telephone | 9729978000 |
| Mailing Fax Number | 9722340813 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA0124 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA01024 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 204712803 | 05 | |
| TX | 204712805 | 05 | |
| TX | 361638502 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041830 | Amy Stacey | Physician Assistant | 502 W Saint Louis St Ste 4, West Frankfort, IL 62896-1968 | 2019-12-24 |
| 1730548363 | Amy Lynne Stacey | Internal Medicine | 234 Goodman St, Cincinnati, OH 45219-2364 | 2016-02-10 |
| 1841579083 | Amy Marie Stacey | Nurse Practitioner | 600 Highland Ave, Madison, WI 53792-0001 | 2011-08-05 |
| 1902981251 | Amy Marie Stacey | Registered Nurse | Usahc Bamberg, Unit 27528, Apo Ae, NY 09139 | 2006-10-26 |
| Street Address |
1300 N 4TH ST |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75601-4717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215581905 | Christi Nichols Williams | Registered Nurse | 1300 N 4th St, Longview, TX 75601-4717 | 2019-07-30 |
| 1447534854 | Devin F Brecheen | Physician Assistant | 1300 N 4th St, Longview, TX 75601-4717 | 2011-10-04 |
| 1295050037 | Lijo John | Internal Medicine | 1300 N 4th St, Longview, TX 75601-4717 | 2010-04-05 |
| 1144554577 | Joseph Charles Hodges II | Radiology | 1300 N 4th St, Longview, TX 75601-4717 | 2009-10-02 |
| 1629246574 | Charlsie Gillcoat | Nurse Practitioner | 1300 N 4th St, Longview, TX 75601-4717 | 2008-02-13 |
| 1629269774 | Matei Paul Socoteanu | Internal Medicine | 1300 N 4th St, Longview, TX 75601-4717 | 2007-08-05 |
| 1841361318 | Eileen B Herbeck | Pharmacist | 1300 N 4th St, Longview, TX 75601-4717 | 2006-11-13 |
| 1235145558 | Monica Sue Ann White | Nurse Practitioner | 1300 N 4th St, Longview, TX 75601-4717 | 2006-07-31 |
| 1851334759 | Neeraj Roshanial Sharma | Internal Medicine | 1300 N 4th St, Longview, TX 75601-4717 | 2006-06-14 |
| 1821031253 | Lewis Alvin Duncan | Internal Medicine | 1300 N 4th St, Longview, TX 75601-4717 | 2006-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992351076 | Stebbins Hospice LLC | Hospice Care, Community Based | 600-602 E. Whaley, Longview, TX 75601 | 2019-08-14 |
| 1720437692 | J.l. Miguez, Inc. | Hearing Aid Equipment | 822 N 4th Street, Longview, TX 75601 | 2016-06-10 |
| 1801244090 | Voyage Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 111 W Tyler St, Longview, TX 75601 | 2016-05-27 |
| 1134504426 | Siobain Kay Rogers | Nurse Practitioner | 703 E Marshall Ave Ste 4003, Longview, TX 75601 | 2015-07-28 |
| 1669882882 | Snehal Shrivastava | Internal Medicine | 1402 N 4th St Ste 300, Longview, TX 75601 | 2014-04-28 |
| 1679824221 | Jennifer Ruth Williams | Occupational Therapist | 110 E Tyler St, Longview, TX 75601 | 2012-09-23 |
| 1548525603 | Candice Renee Ramos | Social Worker | 950 N Sixth St, Longview, TX 75601 | 2012-07-05 |
| 1497082747 | Jarett S Harkness | Pharmacist | 511 E. Marshall Avenue, Longview, TX 75601 | 2009-11-06 |
| 1407086333 | Udeme Ekpenyong | Pediatrics | 818 N. 4th St., Longview, TX 75601 | 2009-07-27 |
| 1386823359 | Assisted Living Concepts Inc | Assisted Living Facility | 2104 Alpine Road, Longview, TX 75601 | 2007-10-26 |
| Find all providers in zip 75601 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| 1881100808 | Mackenzie Cole | Physician Assistant | 323 E Hawkins Pkwy Ste A, Longview, TX 75605-8162 | 2017-12-28 |
| 1053647966 | Jesse R Shaffer | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2009-10-27 |
| 1629097621 | Christine L Matthews | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2310 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
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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.