STACY WALTERS (NPI# 1659383479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659383479 |
| Entity Type | Individual |
| Full Name | STACY WALTERS |
| Credential | M.D. |
| Practice Address |
3100 E Eisenhower Pkwy Suite 100 Ann Arbor MI 48108-5205 |
| Mailing Address |
2100 Commonwealth Blvd Suite 202 Ann Arbor MI 48105-1593 |
| Practice Telephone | 7349719344 |
| Practice Fax Number | 7349712303 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301069953 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
3100 E EISENHOWER PKWY SUITE 100 |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48108-5205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962473637 | Roger Anderberg | Pediatrics | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2006-01-30 |
| 1558845123 | Kirsten J Henshaw | Dentist | 3100 E Eisenhower Pkwy, Ann Arbor, MI 48108-5205 | 2018-09-19 |
| 1013379890 | Mimika Stefos | Dentist | 3100 E Eisenhower Pkwy, #300, Ann Arbor, MI 48108-5205 | 2016-03-22 |
| 1306014816 | Ann Arbor Dental Specialists | Dentist | 3100 E Eisenhower Pkwy, Suite 200, Ann Arbor, MI 48108-5205 | 2008-02-19 |
| 1972641512 | Janice Grichor | Dietitian, Registered | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2007-02-04 |
| 1528111077 | Patricia Hall | Nurse Practitioner | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2007-01-19 |
| 1427121060 | Madelyn Mcmurtrie | Nurse Practitioner | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2006-11-15 |
| 1891893855 | Virginia Bareham | Nurse Practitioner | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2006-09-20 |
| 1568560605 | Vicki Zilke | Nurse Practitioner | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2006-09-20 |
| 1114939931 | Steven Popper | Pediatrics | 3100 E Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108-5205 | 2006-08-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999249 | Creating Brighter Futures | Behavioral Analyst | 4201 Varsity Drive, Ste. C, Ann Arbor, MI 48108 | 2020-07-21 |
| 1326506320 | Michelle Bishop | Behavior Technician | 4935 Birch Hollow Dr, Ann Arbor, MI 48108 | 2019-03-08 |
| 1407326077 | Alexis Ewald | Behavior Technician | 2770 Carpenter Rd., Ann Arbor, MI 48108 | 2018-11-27 |
| 1003308511 | Ann Arbor Dental Specialists | Dentist | 3100 Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108 | 2018-05-31 |
| 1144719295 | Jonathan Parker Etter | Physical Medicine & Rehabilitation | 325 E. Eisenhower, Suite 300, Spc 5744, Ann Arbor, MI 48108 | 2018-05-04 |
| 1427555895 | Blossom Health Services LLC | Social Worker | 2156 Glencoe Hills Dr Apt 12, Ann Arbor, MI 48108 | 2018-04-11 |
| 1669974580 | Camron Anthony Moorehead | Occupational Therapist | 400 E. Eisenhower Parkway Bldg 2, Ste A, Ann Arbor, MI 48108 | 2018-03-07 |
| 1396247862 | Crystal Ann D'agostino | Health Educator | 1169 Oak Valley Drive, Ann Arbor, MI 48108 | 2018-03-01 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1003355546 | Rachael Connolly | Behavior Technician | 4201 Varsity Drive Suite C, Ann Arbor, MI 48108 | 2017-02-16 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553597 | Emile Muallem | Pediatrics | 1500 E. Med. Ctr Dr, Ann Arbor, MI 48109-5718 | 2019-05-17 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
| 1396239992 | Christina Sloan-heggen | Pediatrics | 1500 E. Medical Center Drive., Medical Professional Building D-3230, Ann Arbor, MI 48109 | 2018-06-18 |
| 1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
| 1528598489 | Allison Shewmake | Pediatrics | 1500 E Med Ctr Dr, Spc 5718, Ann Arbor, MI 48109-5718 | 2017-06-14 |
| 1821528928 | Caroline West | Pediatrics | 1500 E. Med. Ctr. Dr., Spc 5718, Ann Arbor, MI 48109-5718 | 2017-06-13 |
| 1083142418 | Aaron M. Schuh | Pediatrics | 1600 E. Med. Ctr. Dr., Mpb Spc 5718, Ann Arbor, MI 48109-5718 | 2017-05-30 |
| 1154858769 | Hira Rashid | Pediatrics | 1500 E. Medical Ctr. Dr., Spc 5718, Ann Arbor, MI 48109-5718 | 2017-05-12 |
| 1225443609 | David Svilar | Pediatrics | 1500 E Medical Center Dr Rm D4202, Ann Arbor, MI 48109-5000 | 2014-06-24 |
| 1669885125 | Phoebe Day Danziger | Pediatrics | 400 E Eisenhower Pkway, Ann Arbor, MI 48108-3302 | 2014-06-03 |
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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.