STACY M FAIREY (NPI# 1033739214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033739214 |
| Entity Type | Individual |
| Full Name | STACY M FAIREY |
| Credential | RDN |
| Practice Address |
1805 Clark Hills Cir Johns Island SC 29455-7603 |
| Practice Telephone | 8438600683 |
| Mailing Telephone | 8438600683 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1501X |
| Street Address |
1805 CLARK HILLS CIR |
| City | JOHNS ISLAND |
| State | SC |
| Zip Code | 29455-7603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689216863 | Live for Wellness Johns Island | Chiropractor | 1803 Crowne Commons Way, Suite 1-a, Johns Island, SC 29455 | 2019-10-09 |
| 1588180186 | Ashley Nicole Cox | Specialist/Technologist | 24 Surfsong Rd, Johns Island, SC 29455 | 2017-08-16 |
| 1568820173 | Bernard Mansheim | Internal Medicine | 3226 Maybank Highway Ste 1a, Johns Island, SC 29455 | 2016-02-10 |
| 1932527843 | Gordon Theodore Davis | General Practice | 3226 Maybank Highway Suite 1-a, Barrier Islands Free Medical Clinics, Johns Island, SC 29455 | 2014-03-29 |
| 1568749596 | Dawn Lachelle Sykes | Chiropractor | 3029 Maybank Highway, Suite 1, Johns Island, SC 29455 | 2011-11-04 |
| 1265765994 | Raymond David Mulligan | Psychologist | 431 Snowy Egret Lane, Kiawah Island, SC 29455 | 2009-09-14 |
| 1912172636 | Nicole Marie Juntz | Chiropractor | 3069 Maybank Hwy, Johns Island, SC 29455 | 2008-04-23 |
| 1972701803 | Village Optical LLC | Optometrist | 634 Freshfields Drive, Johns Island, SC 29455 | 2007-07-03 |
| 1902982945 | John Patrick Howard | Dentist | 1684 Brownswood Rd., Our Lady of Mercy Outreach, Johns Island, SC 29455 | 2006-10-31 |
| 1265515795 | Vincents Drug Store and Soda Fountain | Pharmacy | 110 Planted Row Lane, Johns Island, SC 29455 | 2006-10-20 |
| Find all providers in zip 29455 | ||||
| City | JOHNS ISLAND |
| Zip Code | 29455 |
Please comment or provide details below to improve the information on STACY M FAIREY.
| 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.