JAMES RUSSELL KELLER STACKHOUSE (NPI# 1750517710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750517710 |
| Entity Type | Individual |
| Full Name | JAMES RUSSELL KELLER STACKHOUSE |
| Credential | MD |
| Practice Address |
6 S 14th St Fernandina FL 32034 |
| Mailing Address |
6 S 14th St Fernandina Beach FL 32034-3212 |
| Practice Telephone | 9042615741 |
| Practice Fax Number | 9042617383 |
| Mailing Telephone | 9042615741 |
| Mailing Fax Number | 9042617383 |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2020-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 770778 | GA | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | ME117902 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100661200 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1430 Tulane Ave # Sl-69, Tulane Medical School, New Orleans, LA 701122632 | 5049885804 | |
| 31 S 6th St, Macclenny, FL 320632311 | 9042615741 | 9042617383 |
| 542069 Us Highway 1, Callahan, FL 320118110 | 9042615741 | 9042617383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730177494 | James Timothy Stackhouse | Nurse Anesthetist, Certified Registered | Us Hwy 491 North, Shiprock, NM 87420 | 2005-10-07 |
| Street Address |
6 S 14TH ST |
| City | FERNANDINA |
| State | FL |
| Zip Code | 32034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538655014 | Russell Stackhouse Md Pa | Ophthalmology | 6 S 14th St, Fernandina, FL 32034-3212 | 2018-07-08 |
| 1174972111 | Leah Lentz Herron | Optometrist | 6 S 14th St, Fernandina, FL 32034 | 2016-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871059899 | Anna Fn Chu | Dietitian, Registered | Baptist Medical Center Nassau, 1250 South 18th Street, Fernandina Beach, FL 32034 | 2019-02-14 |
| 1841784550 | Kelly Ann Sayers | Social Worker | 1890 S 14th St Ste 110, Fernandina Beach, FL 32034 | 2018-06-15 |
| 1609302611 | Christian Giovanniello | Behavior Technician | 1743 Azalea Street, Fernandina Beach, FL 32034 | 2017-05-11 |
| 1770018467 | Beckerton Chiropractic Pllc | Chiropractor | 464073 East State Road 200, Yulee, FL 32034 | 2017-05-01 |
| 1114392438 | Jayde Marie Gray | Chiropractor | 5211 South Fletcher Ave., Suite 250, Amelia Island, FL 32034 | 2015-12-11 |
| 1760858369 | Sun Gallery Inc. | Eyewear Supplier (Equipment, not the service) | 1523 Sadler Road, Fernandina Beach, FL 32034 | 2015-08-18 |
| 1124419718 | Angela L Michels | Counselor | 1890 S. 14th St., #302, Fernandina Beach, FL 32034 | 2015-02-18 |
| 1336542075 | Sara Veronica Herreros | Physician Assistant | 1865 Lime Street, Suite 100, Fernandina Beach, FL 32034 | 2014-10-08 |
| 1366789471 | Elizabeth Ann Moore | Nurse Practitioner | 1348 S 18th St Ste 340, Fernandina Beach, FL 32034 | 2013-01-09 |
| 1043564289 | Summer Suzanne Delille | Dental Hygienist | 95054 Oriole St., Fernandina Beach, FL 32034 | 2012-11-08 |
| Find all providers in zip 32034 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538655014 | Russell Stackhouse Md Pa | Ophthalmology | 6 S 14th St, Fernandina, FL 32034-3212 | 2018-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740888353 | Jonathan M Frantz, Md Pa | Ophthalmology | 18500 Veterans Blvd Unit 4, Port Charlotte, FL 33954-1035 | 2020-10-15 |
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1770191231 | Eyerad, Pllc | Ophthalmology | 6280 W Sample Road #202, Coral Springs, FL 33067-3173 | 2020-07-21 |
| 1609494566 | Eye Specialists of Mid Florida, Pa | Ophthalmology | 3350 Harden Blvd, Lakeland, FL 33803-7939 | 2020-07-08 |
| 1811511207 | Tampa Bay Ophthalmic Plastics LLC | Ophthalmology | 2963 Gulf To Bay Blvd, Ste 267, Clearwater, FL 33759-4259 | 2020-06-02 |
| 1841819166 | St. Lucie Eye Associates, M.d. P.a. | Ophthalmology | 1715 S.e Tiffany Ave., Port St. Lucie, FL 34952-7511 | 2020-04-16 |
| 1477172708 | St. Lucie Eye Associates, M.d., P.a. | Ophthalmology | 1302 S.w. St. Lucie West Blvd., Port St. Lucie, FL 34986-2109 | 2020-04-16 |
| 1598393142 | Samuel Richard Bierstock | Ophthalmology | 417 Palm Trail, Delray Beach, FL 33483 | 2020-03-30 |
| 1144858721 | Citrus Eye Care, Pa | Ophthalmology | 10549 Deerberry Dr, Land O Lakes, FL 34638-6948 | 2020-03-30 |
| 1922632066 | St Cloud Eye Center Inc | Ophthalmology | 4589 Henry C Yates Lane, Saint Cloud, FL 34769-3476 | 2020-02-27 |
| Find all providers with the same taxonomy | ||||
| City | FERNANDINA |
| Zip Code | 32034 |
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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.