STACEY A ROBERTSON (NPI# 1346201274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346201274 |
| Entity Type | Individual |
| Full Name | STACEY A ROBERTSON |
| Credential | DO |
| Practice Address |
802 Mckinley St Bolivar Medical Center Bolivar PA 15923 |
| Mailing Address |
Po Box 38 Bolivar PA 15923-0038 |
| Practice Telephone | 7246764709 |
| Practice Fax Number | 7246764752 |
| Mailing Telephone | 7246764709 |
| Mailing Fax Number | 7246764752 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2011-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | O5004404L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 101206165 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548757537 | Stacey K Robertson | Counselor | 8023 Benson St, New Orleans, LA 70127 | 2018-04-16 |
| 1245577600 | Stacey L Robertson | Acupuncturist | 14140 E Bellewood Dr, Aurora, CO 80015-1180 | 2013-01-04 |
| 1326178401 | Stacey Eugene Robertson | Counselor | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2007-03-06 |
| Street Address |
802 MCKINLEY ST BOLIVAR MEDICAL CENTER |
| City | BOLIVAR |
| State | PA |
| Zip Code | 15923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386285724 | Rebecca R Fetter | Counselor | 412 Shaffer Street, Bolivar, PA 15923 | 2019-10-07 |
| 1396074324 | Primary Health Network | Clinic/Center | 802 Mckinley Street, Bolivar, PA 15923-0038 | 2009-12-22 |
| 1740469303 | Outside In School of Experiential Education, Inc | Substance Abuse Rehabilitation Facility | 1050 Fort Palmer Rd, Bolivar, PA 15923-2516 | 2007-10-31 |
| 1285074591 | Justin T. Mcdonald | Counselor | 1050 Fort Palmer Rd, Bolivar, PA 15923-2516 | 2013-07-01 |
| 1912153842 | Outside In Scholl of Experiential Education | Substance Abuse Rehabilitation Facility | 196 Hamill School Rd, Bolivar, PA 15923-2525 | 2008-08-12 |
| 1780134171 | Outside In School of Experiential Education, Inc | Community/Behavioral Health | 196 Hamill School Rd, Bolivar, PA 15923-2525 | 2016-10-10 |
| 1457739674 | Barbara Penn | Social Worker | 196 Hamill School Rd, Bolivar, PA 15923-2525 | 2015-05-07 |
| 1033549209 | Outside In School of Experiential Education, Inc. | Community/Behavioral Health | 196 Hamill School Rd, Bolivar, PA 15923-2525 | 2013-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1952915761 | Carol Ehrhardt | Speech-Language Pathologist | 620 E Destin Ln, Bolivar, MO 65613-2253 | 2020-08-31 |
| 1811514672 | Joshua Charles Layman | Physical Therapist | 2103 S Springfield Ave, Bolivar, MO 65613-9686 | 2020-06-28 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1720603459 | Cassandre D. Viets | Registered Nurse | 1155 W Parkview St Ste 1c, Bolivar, MO 65613-7800 | 2020-06-09 |
| 1851915706 | Albany Place LLC | Home Health | 520 S Albany Ave, Bolivar, MO 65613-2116 | 2020-06-05 |
| 1538781679 | David R Richie | Psychologist | 680 Russell Rd, Bolivar, TN 38008-3573 | 2020-05-12 |
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| Find all providers in BOLIVAR | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1134255078 | Robert Wayne Dunavant | Family Medicine | 610 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-02-26 |
| 1326110818 | George J Heinz IIi | Family Medicine | 1500 N. Oakland Ave., Bolivar, MO 65613 | 2006-11-14 |
| 1871692798 | Greg Link | Family Medicine | 3817 S Springfield Ave, Suite 140, Bolivar, MO 65613-9129 | 2006-09-21 |
| 1114930716 | Monte R Kahler | Family Medicine | 1125 N Butterfield, Bolivar, MO 65613 | 2006-08-14 |
| 1023029998 | Kristopher J Kaufmann | Family Medicine | 1125 N Butterfield Rd, Bolivar, MO 65613-1056 | 2006-08-10 |
| 1346283413 | Associates In Medicine, Inc | Family Medicine | 630 E Buffalo St, Bolivar, MO 65613-2619 | 2006-06-14 |
| 1417901935 | Juris Peteris Simanis | Family Medicine | 1155 W. Parkview Street, Suite 2d, Bolivar, MO 65613-7800 | 2006-05-20 |
| 1649248840 | Mark Andrew Hillyer | Family Medicine | 10724 State Route 212 Ne, Bolivar, OH 44612-8740 | 2006-03-14 |
| 1902893258 | Trans South Health Care PC | Family Medicine | 622 W Market St, Suite 100, Bolivar, TN 38008-2241 | 2005-10-03 |
| Find all providers in BOLIVAR | ||||
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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.