STACEY S HODGES (NPI# 1104814805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104814805 |
| Entity Type | Individual |
| Full Name | STACEY S HODGES |
| Credential | ACNP |
| Practice Address |
9 Physicians Dr Jackson TN 38305 |
| Mailing Address |
Po Box 11567 Jackson TN 38308 |
| Practice Telephone | 7316610086 |
| Practice Fax Number | 7316610281 |
| Mailing Telephone | 7316610086 |
| Mailing Fax Number | 7316610281 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2011-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | RN105802 | TN | Nursing Service Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APN 7203 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN105802 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3902598 | 05 | |
| DEA | MH0593346 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619575552 | Stacey Hodges | Registered Nurse | 69 Lucy Ln, Cheektowaga, NY 14225-4437 | 2020-10-13 |
| 1831569185 | Stacey Hodges | Physical Therapy Assistant | 435 Doe Run Rd, Rocky Mount, VA 24151-6168 | 2015-09-30 |
| 1316284631 | Stacey Barbara Hodges | Counselor | 3307 Northlake Blvd, #b104, Palm Beach Gardens, FL 33403-1703 | 2013-01-07 |
| 1649408865 | Stacey L Hodges | Marriage & Family Therapist | 1125 W Spruce St, Olathe, KS 66061-3123 | 2009-06-25 |
| 1962549030 | Stacey Anne Hodges | Occupational Therapist | 502 N 9th Ave, Vinton, IA 52349-2254 | 2007-01-30 |
| Street Address |
9 PHYSICIANS DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700873056 | Allan M Menachem | Internal Medicine | 9 Physicians Dr, Jackson, TN 38305-2071 | 2005-10-03 |
| 1306389903 | Anahita Meshkani | Nurse Practitioner | 9 Physicians Dr, Jackson, TN 38305-2071 | 2016-11-30 |
| 1194149385 | Wendy Burks Pevahouse | Nurse Practitioner | 9 Physicians Dr, Jackson, TN 38305-2071 | 2014-02-10 |
| 1528482809 | Brittany Harris | Registered Nurse | 9 Physicians Dr, Jackson, TN 38305-2071 | 2014-02-07 |
| 1164762498 | Brittney Jaynes Tucker | Nurse Practitioner | 9 Physicians Dr, Jackson, TN 38305 | 2013-02-23 |
| 1689982431 | Tennessee Anesthesia Network Services LLC | Anesthesiology | 9 Physicians Dr, Jackson, TN 38305-2071 | 2010-09-15 |
| 1396063012 | Jackson Medical Services | Nurse Anesthetist, Certified Registered | 9 Physicians Dr, Jackson, TN 38305-2071 | 2010-05-05 |
| 1891770921 | Linda Renee Miller | Internal Medicine | 9 Physicians Dr, Jackson, TN 38305-2071 | 2005-12-13 |
| 1740277821 | Transsouth Health Care PC | Clinic/Center | 9 Physicians Dr, Jackson, TN 38305-2071 | 2005-10-04 |
| 1316934664 | Bob T Souder | Internal Medicine | 9 Physicians Dr, Jackson, TN 38305-2071 | 2005-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700240397 | Veronique Monique Lynch | Nurse Practitioner | 963 Toms River Rd, Jackson, NJ 08527-5239 | 2016-04-08 |
| 1821423484 | Katherine G Lott | Nurse Practitioner | 6295 Old Canton Rd, Apt 23b, Jackson, MS 39211-2908 | 2013-09-13 |
| 1760618292 | Matthew Edward Flynn | Nurse Practitioner | 971 Lakeland Dr Ste 1052, Jackson, MS 39216-4609 | 2009-06-10 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1437785508 | Katey Andrews | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-03-20 |
| 1144854498 | Katlyn Amason | Nurse Practitioner | 501 Marshall St Ste 200, Jackson, MS 39202-1687 | 2020-02-25 |
| 1194364554 | Erica L Hawkins | Nurse Practitioner | 900 Cooper St, Jackson, MI 49202-3398 | 2020-01-03 |
| 1023664430 | Jennifer Elizabeth Overton | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2019-08-12 |
| Find all providers in JACKSON | ||||
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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.