STACY SHULTZ (NPI# 1144736398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144736398 |
| Entity Type | Individual |
| Full Name | STACY SHULTZ |
| Practice Address |
8920 Southpointe Dr Ste B Indianapolis IN 46227 |
| Mailing Address |
6626 E 75th St Ste 500 Indianapolis IN 46250-2890 |
| Practice Telephone | 3174971900 |
| Practice Fax Number | 3174971919 |
| Mailing Telephone | 3174971900 |
| Mailing Fax Number | 3174971919 |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2020-09-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71007710A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28169780A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300028901 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 40 S Alabama St, Indianapolis, IN 462043635 | 3173271711 |
| Street Address |
8920 SOUTHPOINTE DR STE B |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639110943 | Brian R Darrisaw | Internal Medicine | 8920 Southpointe Dr Ste B, Indianapolis, IN 46227-7505 | 2006-06-09 |
| 1598921132 | Brenda Louise Korte | Nurse Practitioner | 8920 Southpointe Dr Ste B, Indianapolis, IN 46227 | 2008-08-04 |
| 1174786578 | Cynthia Ebini | Family Medicine | 8920 Southpointe Dr Ste B, Indianapolis, IN 46227-7505 | 2008-07-07 |
| 1013170448 | Phumeza Msikinya | Family Medicine | 8920 Southpointe Dr Ste B, Indianapolis, IN 46227 | 2008-07-07 |
| 1265447981 | Stacia E Sorrell | Family Medicine | 8920 Southpointe Dr Ste B, Indianapolis, IN 46227-7505 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184477 | Zachry Skinner | Specialist/Technologist | 1683 E Hanna Ave, Indianapolis, IN 46227 | 2020-08-14 |
| 1104481415 | Corinne Mcdonald | Music Therapist | 7502 Madison Avenue, Indianapolis, IN 46227 | 2019-05-02 |
| 1205318649 | Kesha Conner | Counselor | 8320 Madison Ave Indianapolis, In, Indianapolis, IN 46227 | 2018-09-01 |
| 1609369719 | Victoria Lynn West Arnold | Physician Assistant | 1550 E County Line Rd Ste 320, Indianapolis, IN 46227 | 2018-06-13 |
| 1518466960 | Debra Cottongim | Physical Therapy Assistant | 6329 South East St, Ste A, Indianapolis, IN 46227 | 2018-02-12 |
| 1962943019 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6826 Madison Ave, Indianapolis, IN 46227 | 2017-03-09 |
| 1205386687 | Kylie Rochelle Bontrager | Dentist | 3658 East Street, Indianapolis, IN 46227 | 2016-10-10 |
| 1013371137 | Kayla Ford | Occupational Therapist | 3230 Rue Chanel, Apt 162, Indianapolis, IN 46227 | 2016-04-06 |
| 1639551344 | Sara Allyn Shrivastav | Technician, Other | 3711 E Southport Rd, Indianapolis, IN 46227 | 2015-06-18 |
| 1598146565 | Theodore Christian Seger | Family Medicine | 610 E Southport Rd Ste 205, Indianapolis, IN 46227 | 2015-06-15 |
| Find all providers in zip 46227 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1922614965 | Children Express Care Clinic LLC | Nurse Practitioner | 5435 Emerson Way Ste 110, Indianapolis, IN 46226-1470 | 2020-09-16 |
| 1255956272 | Heather Nicole Zore | Nurse Practitioner | 9240 N Meridian St Ste 225, Indianapolis, IN 46260-1880 | 2020-06-15 |
| 1457976615 | Adam Weir | Nurse Practitioner | 960 E Washington St, Indianapolis, IN 46202-3981 | 2020-06-13 |
| 1457975740 | Ayee Teah Bleemie | Nurse Practitioner | 429 E Vermont St Ste 100, Indianapolis, IN 46202-3688 | 2020-06-02 |
| 1689294357 | May Josefa Ishikawa | Nurse Practitioner | 705 Riley Hospital Dr Ste 2240, Indianapolis, IN 46202-5109 | 2020-04-22 |
| 1760001200 | John Shaver | Nurse Practitioner | 3750 N Meridian St Ste 100, Indianapolis, IN 46208-4300 | 2020-04-14 |
| 1851931000 | Robin L Petit | Nurse Practitioner | 6925 S Harding St Ste B-1, Indianapolis, IN 46217-4114 | 2020-01-15 |
| 1952941577 | Andreya Beckett | Nurse Practitioner | 3500 Depauw Blvd Ste 1041, Indianapolis, IN 46268-6125 | 2020-01-11 |
| 1053950105 | Shannon Malecki | Nurse Practitioner | 550 University Blvd Ste 5630, Indianapolis, IN 46202-5149 | 2020-01-06 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46227 |
Please comment or provide details below to improve the information on STACY SHULTZ.
| 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.