Homer L Staley (NPI# 1609886936, PAC ID# 2961455258) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1609886936 |
| PAC ID by PECOS | 2961455258 |
| Professional Enrollment ID | I20050228000078 |
| Full Name | Homer L Staley |
| Address |
104 N Locust Ave Lawrenceburg TN 38464-3734 |
| Gender | M |
| Credential | MD |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1973 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440175 | SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM LAWRENCE |
| 440073 | MAURY REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 104 N Locust Ave, Lawrenceburg, TN 38464-3734 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 87% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Street Address |
104 N LOCUST AVE |
| City | LAWRENCEBURG |
| State | TN |
| Zip | 38464-3734 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kenneth L Will | Certified Registered Nurse Anesthetist (crna) | Medstream Anesthesia Pllc | 1607s Locust Ave Hwy 43, Lawrenceburg, TN 38464 |
| Jason Arden Mccawley | Certified Registered Nurse Anesthetist (crna) | Medstream Anesthesia Pllc | 1607s Locust Ave Hwy 43, Lawrenceburg, TN 38464 |
| Shonda Danielle Morris | Nurse Practitioner | Mid-tennessee Family Health Center | 110 Weakley Creek Rd, Lawrenceburg, TN 38464-2238 |
| Kellie D Coffey | Nurse Practitioner | Mid-tennessee Family Health Center | 110 Weakley Creek Rd, Lawrenceburg, TN 38464-2238 |
| Richard D Kennedy | Family Medicine | Mid-tennessee Family Health Center | 110 Weakley Creek Rd, Lawrenceburg, TN 38464-2238 |
| Wanda Moore | Nurse Practitioner | Mid-tennessee Family Health Center | 110 Weakley Creek Rd, Lawrenceburg, TN 38464-2238 |
| Racheal M Kightlinger | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Haley Beecham Phillips | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Leslie N Bedford | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Christopher Chase Davis | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Find all physicians in zip 38464 | |||
| City | LAWRENCEBURG |
| Zip Code | 38464 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LAWRENCEBURG + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Homer L Staley.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.