DR. STACY BRIAN ELLISON (NPI# 1093843484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093843484 |
| Entity Type | Individual |
| Full Name | DR. STACY BRIAN ELLISON |
| Credential | D.M.D. |
| Practice Address |
2831 S Hurstbourne Pkwy Louisville KY 40220-4112 |
| Practice Telephone | 5024910330 |
| Practice Fax Number | 5024917431 |
| Mailing Telephone | 5024910330 |
| Mailing Fax Number | 5024917431 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5989 | KY | Dental Providers |
| Street Address |
2831 S HURSTBOURNE PKWY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40220-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076153 | Dennis A Sparks | Family Medicine | 2831 S Hurstbourne Pkwy, Suite B, Louisville, KY 40220-4121 | 2005-07-08 |
| 1316565377 | Stevie Riedley | Behavioral Analyst | 2831 S Hurstbourne Pkwy, Louisville, KY 40220-4112 | 2020-07-07 |
| 1386946952 | Dennis A Sparks Md Inc | Family Medicine | 2831 S Hurstbourne Pkwy, Louisville, KY 40220-4112 | 2010-12-02 |
| 1700960200 | Kps Suites, LLC | Clinic/Center | 2831 S Hurstbourne Pkwy, Ste A, Louisville, KY 40220-4112 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502560 | Louis James Walker IIi | Physical Therapist | 8904 Elks Bluff Drive, Unit 02206, Apt 206, Louisville, KY 40220 | 2020-09-10 |
| 1396207148 | Kristan Shay Swindler | Specialist/Technologist, Other | 3008 Furman Blvd., Louisville, KY 40220 | 2019-04-02 |
| 1033686191 | Reine Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3405 Breckenridge Lane, Louisville, KY 40220 | 2018-10-26 |
| 1053828145 | Angelique Marie Leist | Registered Nurse | 3103 Breckenridge Ln Ste 1, Louisville, KY 40220 | 2018-01-10 |
| 1811413925 | Virginia Zimlich | Physical Therapist | 2807 Alice Ave, Louisville, KY 40220 | 2017-08-21 |
| 1255860649 | Susan Marie Elder | Registered Nurse | 2816 Esther Blvd, Louisville, KY 40220 | 2017-06-08 |
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1639547987 | Meghan Hillerich | Home Health | 13 Canterbury Drive, Louisville, KY 40220 | 2015-09-03 |
| 1376921098 | Dental Services of Kentucky, Psc | Dentist | 3946 Taylorsville Rd., Louisville, KY 40220 | 2015-05-14 |
| 1093103574 | Joann Bartolone Murphy | Developmental Therapist | 3717 Taylorsville Rd., Louisville, KY 40220 | 2015-01-06 |
| Find all providers in zip 40220 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235781485 | Rylie Mike-mayer | Dentist | 302 Axis Dr Apt 401, Louisville, KY 40206-0139 | 2019-07-09 |
| 1922580653 | Advanced Dental Center, Inc. | Dentist | 1901 Rudy Ln Ste 4, Louisville, KY 40207-1384 | 2018-08-29 |
| 1043701451 | Diana H Tran | Dentist | 501 S Preston St Rm 148, Louisville, KY 40202-1701 | 2018-05-21 |
| 1992295653 | Tyler Benton Blount | Dentist | 8013 New La Grange Rd Ste 6, Louisville, KY 40222-4700 | 2018-05-17 |
| 1407346901 | Louisville Dental Associates LLC | Dentist | 16701 E Main St, Louisville, MS 39339-2751 | 2018-05-10 |
| 1194238816 | Dental Services of Kentucky, Psc | Dentist | 2011 Grinstead Dr Unit 102, Louisville, KY 40204-1296 | 2017-11-16 |
| 1366963373 | Caleb William Reece | Dentist | 2201 Biljana Dr Apt 1, Louisville, KY 40206-2175 | 2017-06-29 |
| 1205366846 | Triple Crown Dentistry | Dentist | 904 Lily Creek Road, Suite 101, Louisville, KY 40243 | 2017-06-15 |
| 1740733559 | Jonathan Mitchell, Dmd, Psc | Dentist | 1716 Gardiner Ln, Louisville, KY 40205-2738 | 2016-07-27 |
| 1215389168 | Charles Kendrick Bunch | Dentist | 1030 Mulberry St, Louisville, KY 40217-1253 | 2016-07-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40220 |
Please comment or provide details below to improve the information on DR. STACY BRIAN ELLISON.
| 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.