JESSE A STAFFORD (NPI# 1316338361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316338361 |
| Entity Type | Individual |
| Full Name | JESSE A STAFFORD |
| Credential | P.A.-C |
| Practice Address |
346 N Main St Decatur AR 72722-9732 |
| Mailing Address |
Po Box 735 Decatur AR 72722-0735 |
| Practice Telephone | 4797523233 |
| Practice Fax Number | 4797523235 |
| Mailing Telephone | 4797523233 |
| Mailing Fax Number | 4797523235 |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-598 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669786430 | Jesse Allen Stafford | Dentist | 516 W Arapaho Rd Ste 103, Richardson, TX 75080-4342 | 2010-08-03 |
| 1306896543 | Jesse Ray Stafford | Pathology | 8 Memorial Medical Ct, Suite 1, Greenville, SC 29605-4455 | 2006-05-10 |
| Street Address |
346 N MAIN ST |
| City | DECATUR |
| State | AR |
| Zip Code | 72722-9732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477511434 | Jeff Paul Honderich | Family Medicine | 346 N Main St, Decatur, AR 72722-9732 | 2006-05-01 |
| 1871013359 | Laticia Kay Sheffield | Family Medicine | 346 N Main St, Decatur, AR 72722-9732 | 2017-06-26 |
| 1629493549 | Mitchell Atkins | Nurse Practitioner | 346 N Main St, Decatur, AR 72722-9732 | 2014-02-28 |
| 1205848249 | John L Garrett | Family Medicine | 346 N Main St, Decatur, AR 72722-0735 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538244504 | Jerry Lee Young | Pharmacist | 154 Main St, Decatur, AR 72722 | 2006-10-26 |
| 1992842595 | Veronica G Dockery | Physician Assistant | 346 N. Main St, Decatur, AR 72722-0735 | 2007-01-31 |
| 1023028016 | Spavinaw Clinics, Inc | Clinic/Center | 346 N. Main Street, Decatur, AR 72722-0735 | 2006-08-09 |
| 1194330951 | Melissa Logan | Registered Nurse | 8099 Warren Rd, Decatur, AR 72722-9406 | 2020-09-09 |
| 1952704892 | Wal-mart Stores Inc | Pharmacy | 154 E Roller Ave, Decatur, AR 72722-9446 | 2014-10-07 |
| 1053461004 | Decatur School District | Local Education Agency (LEA) | 1441 E Roller Ave, Decatur, AR 72722-9650 | 2007-01-11 |
| 1821435108 | Decatur Public Schools | Local Education Agency (LEA) | 1498 Stadium Ave, Decatur, AR 72722-9780 | 2013-05-28 |
| 1639496425 | Kyndel Hope Brecheisen | Nurse Practitioner | 250 S Main St, Decatur, AR 72722-9782 | 2010-05-03 |
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1073904181 | Nathan Potter | Physician Assistant | 798 Larry Ln, Decatur, GA 30033-4817 | 2015-02-11 |
| 1932467479 | Shannon L Hill | Physician Assistant | 1074 Ashbury Dr, Decatur, GA 30030-4165 | 2012-05-02 |
| 1578754792 | John Cicero Crawford II | Physician Assistant | 3941 John Hopkins Ct, Decatur, GA 30034-5709 | 2007-08-05 |
| 1437299773 | Barbar A Young | Physician Assistant | 3290 Memorial Dr Ste B3, Decatur, GA 30032-3400 | 2007-02-07 |
| 1992842595 | Veronica G Dockery | Physician Assistant | 346 N. Main St, Decatur, AR 72722-0735 | 2007-01-31 |
| 1649344938 | Telicia Dequai Scott | Physician Assistant | 4153b Flat Shoals Pkwy Ste 200, Decatur, GA 30034-4189 | 2006-11-20 |
| 1699773234 | Joanne Gilby Beer | Physician Assistant | 3292 Mountain Dr Ste A, Decatur, GA 30032-1102 | 2005-07-08 |
| 1871063263 | Paige Birge | Physician Assistant | 2300 N Edward St, Decatur, IL 62526-4163 | 2018-11-28 |
| Find all providers in DECATUR | ||||
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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.