STACEY C BOHM (NPI# 1508484031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508484031 |
Entity Type | Individual |
Full Name | STACEY C BOHM |
Credential | AGACNP-BC |
Practice Address |
15720 Brixham Hill Ave Ste 130 Charlotte NC 28277-4784 |
Practice Telephone | 7045415555 |
Mailing Telephone | 7045415555 |
Enumeration Date | 2020-07-10 |
Last Update Date | 2020-07-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
0024179203 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
5013293 | NC | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
15720 BRIXHAM HILL AVE STE 130 |
City | CHARLOTTE |
State | NC |
Zip Code | 28277-4784 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124636667 | Select Health Pain and Regenerative Medicine PC | Nurse Practitioner | 15720 Brixham Hill Ave Ste 130, Charlotte, NC 28277-4784 | 2020-07-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
Find all providers in zip 28277 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316544927 | Christine Marie Davis | Nurse Practitioner | 1010 Kenilworth Ave Apt 426, Charlotte, NC 28204-3475 | 2020-10-06 |
1841891033 | Amber Maurer Ettell | Nurse Practitioner | 125 Queens Rd Ste 420, Charlotte, NC 28204-3215 | 2020-11-04 |
1962015420 | Randall Lee Coffman | Nurse Practitioner | 200 Hawthorne Ln, Charlotte, NC 28204-2515 | 2020-08-25 |
1699388116 | Cassandra L. Barnes | Nurse Practitioner | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2020-08-25 |
1407469927 | Lesley Rummage | Nurse Practitioner | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2020-08-25 |
1437771557 | Danielle Margaret Altieri | Nurse Practitioner | 1010 Edgehill Rd N, Charlotte, NC 28207-1885 | 2020-05-12 |
1689207185 | Advanced Comprehensive Care Pllc | Nurse Practitioner | 11301 Golf Links Dr N, Charlotte, NC 28277-8013 | 2020-02-13 |
1205476843 | Douglas Lowe | Nurse Practitioner | 200 Hawthorne Ln, Charlotte, NC 28204-2515 | 2020-01-12 |
1063963866 | Jessica Puskarich | Nurse Practitioner | 1718 E 4th St, Suite 307, Charlotte, NC 28204-3261 | 2016-10-18 |
1174931034 | Brandlyn Noftsger | Nurse Practitioner | 3030 Randolph Rd, Charlotte, NC 28211-1368 | 2014-07-23 |
Find all providers in CHARLOTTE |
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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.