STACEY MARDIS (NPI# 1144532730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144532730 |
| Entity Type | Individual |
| Full Name | STACEY MARDIS |
| Credential | M.D. |
| Practice Address |
630 E River St Department of Emergency Medicine Elyria OH 44035-5902 |
| Practice Telephone | 4403297450 |
| Mailing Telephone | 4403297450 |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2013-07-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35.121170 | OH | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 35.121170 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
630 E RIVER ST DEPARTMENT OF EMERGENCY MEDICINE |
| City | ELYRIA |
| State | OH |
| Zip Code | 44035-5902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299039 | Emh Regional Medical Center | General Acute Care Hospital | 630 E River St, Elyria, OH 44035-5902 | 2005-07-19 |
| 1467069989 | James Kellogg II | Physician Assistant | 630 E River St, Elyria, OH 44035-5902 | 2020-09-29 |
| 1326651761 | Vicki J Sexstella | Respiratory Therapist, Registered | 630 E River St, Elyria, OH 44035-5902 | 2020-08-25 |
| 1003434952 | Bretzyl M Liscoe | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-07-08 |
| 1760009633 | Ashley Tobicash | Family Medicine | 630 E River St, Elyria, OH 44035-5902 | 2020-06-26 |
| 1144843673 | Johnna Diaz | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-05-19 |
| 1295357911 | Denise N Dalton | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-05-15 |
| 1568094530 | Lori Clark | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-02-07 |
| 1467083501 | Debora Petani | Physician Assistant | 630 E River St, Elyria, OH 44035-5902 | 2020-01-28 |
| 1487292272 | Amy S Newton | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2019-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514546 | Monica Sue Lane | Homemaker | 244 13th St, Elyria, OH 44035 | 2020-10-07 |
| 1457958993 | Joaquin Deandre Page | Homemaker | 116 Parkview Ct, Elyria, OH 44035 | 2020-10-07 |
| 1740887751 | Kelley Jean Duga | Home Health Aide | 46058 Russia Rd, Elyria, OH 44035 | 2020-10-02 |
| 1407477946 | Ashley Langer | Nurse Practitioner | 660 E Broad St, Elyria, OH 44035 | 2020-05-06 |
| 1518593730 | Scott Michael Hartman | Nurse Practitioner | 630 East River Streer, Elyria, OH 44035 | 2020-03-19 |
| 1609415793 | Melanie Scott | Registered Nurse | 830 East Broad St, Uh Hospitals Elyria, Elyria, OH 44035 | 2020-01-06 |
| 1922647478 | Hyatt Family Dental, LLC | Dentist | 301 East Avenue, Elyria, OH 44035 | 2020-01-02 |
| 1255988051 | Ashlee Marie Reale | Student in an Organized Health Care Education/Training Program | 347 Middle Blvd #210, Elyria, OH 44035 | 2019-08-26 |
| 1821656380 | Amber Mahone | Case Manager/Care Coordinator | 342 Midway Blvd Ste 210, Elyria, OH 44035 | 2019-05-30 |
| 1548788151 | Robin Lee Newhart | Physical Therapist | 1885 Lake Avenue, Elyria, OH 44035 | 2017-09-03 |
| Find all providers in zip 44035 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710365788 | Neal Johnson | Emergency Medicine | 630 E River St Ste 403, Elyria, OH 44035-5902 | 2015-05-11 |
| 1588193825 | Michael Francis Kaminski | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2017-06-09 |
| 1659500148 | Lara E Marsh | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2009-07-07 |
| 1063441681 | Allan F Starr | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-07-03 |
| 1376573899 | David P Rickson | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-07-03 |
| 1548298086 | Melissa Jane Marker | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-06-30 |
| 1891723755 | Douglas G Mcdonald | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-06-29 |
| 1821033366 | Judith Toski Welsh | Emergency Medicine | 630 E River St, Emergency Care Center - Emh Regional Medical Center, Elyria, OH 44035-5902 | 2006-06-18 |
| 1679517130 | Daniel P Walsh | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-06-15 |
| 1235172925 | Physicians Link Center LLC | Emergency Medicine | 630 E River St, Elyria, OH 44035-5902 | 2006-06-13 |
| Find all providers in ELYRIA | ||||
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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.