STACEY W JOHNSON (NPI# 1376511667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376511667 |
| Entity Type | Individual |
| Full Name | STACEY W JOHNSON |
| Credential | MD |
| Practice Address |
509 Gordon Ave Thomasville GA 31792 |
| Mailing Address |
Po Box 2258 Thomasville GA 31799 |
| Practice Telephone | 2292267544 |
| Practice Fax Number | 2292260314 |
| Mailing Telephone | 2292267544 |
| Mailing Fax Number | 2292260314 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 041324 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000706439C | 05 | |
| GA | 000706439B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871004382 | Stacey Lin Johnson | Counselor | 303 N Burlington Ave Ste C, Hastings, NE 68901-5085 | 2017-10-24 |
| 1225586126 | Stacey Johnson | Community Health Worker | 30422 Laurelwood Ln, Wesley Chapel, FL 33543-4452 | 2016-09-20 |
| 1083020614 | Stacey Elizabeth Johnson | Counselor | 3419 Ne Sandy Blvd., Portland, OR 97232-1959 | 2014-07-03 |
| 1083036206 | Stacey Johnson | Marriage & Family Therapist | 1056 W 49th St, Los Angeles, CA 90037-2922 | 2014-01-07 |
| 1689005993 | Stacey Johnson | Nurse Practitioner | 4301 W Markham St # 519, Little Rock, AR 72205-7101 | 2013-12-12 |
| 1003116997 | Stacey M Johnson | Registered Nurse | 12605 E 16th Ave Fl Aip23, Aurora, CO 80045-2545 | 2010-10-26 |
| 1033442918 | Stacey K Johnson | Registered Nurse | 150 Landers St, Apt 2, San Francisco, CA 94114-4706 | 2009-09-10 |
| 1821262429 | Stacey Smith Johnson | Dietitian, Registered | 96 Ali Way Creekside South, Oxford, AL 36203 | 2008-04-15 |
| 1467656199 | Stacey Ann Johnson | Speech-Language Pathologist | 2922 N Seeley Ave, Chicago, IL 60618-8211 | 2007-06-14 |
| 1003441379 | Stacey Johnson | Early Intervention Provider Agency | 1002 S Dillard St Ste 106, Winter Garden, FL 34787-3991 | 2020-03-06 |
| Street Address |
509 GORDON AVE |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033186838 | Jose M Grave De Peralta | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-01 |
| 1245682103 | Nicole Simmons | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2016-07-04 |
| 1790178564 | Martha Hanna | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2015-03-18 |
| 1932430832 | Natalie Y Royal | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2010-01-18 |
| 1265635254 | Salli Chism Lehman | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2007-06-07 |
| 1760602783 | The Pediatric Center LLC | Clinic/Center | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2007-05-01 |
| 1023085420 | Timothy A Jones | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-03 |
| 1659348316 | Benjamin J Wilds | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-02 |
| 1629045398 | Holly M Crowley | Psychiatry & Neurology | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-02 |
| 1235106048 | Amy A Cooper | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629614060 | Kaley Adams | Pediatrics | 227 Torrington Blvd, Thomasville, GA 31757-3904 | 2019-11-20 |
| 1306275441 | Robert Maxwell | Pediatrics | 213 Pembroke Pl, Thomasville, GA 31792-6750 | 2013-11-08 |
| 1740527126 | Eugene Coleman Jarrett IIi | Pediatrics | 307 Dunedin Dr, Thomasville, GA 31792-4742 | 2013-01-06 |
| 1790814002 | Minerva C Wheedleton | Pediatrics | 168 Beargrass Trl, Thomasville, GA 31792-7962 | 2007-03-04 |
| 1033186838 | Jose M Grave De Peralta | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-01 |
| 1831721158 | Kaley Everhart Cucci | Pediatrics | 200 Arthur Dr, Thomasville, NC 27360-6275 | 2020-02-05 |
| 1346534799 | Amanda Marie Rose | Pediatrics | 200 Arthur Dr, Thomasville, NC 27360-6275 | 2011-06-02 |
| 1649413600 | Daniel Mark Entwistle | Pediatrics | 200 Arthur Dr, Thomasville, NC 27360-6275 | 2009-04-07 |
| 1699932418 | Quan Johnson | Pediatrics | 200 Arthur Dr, Thomasville, NC 27360-6275 | 2008-05-20 |
| 1821281007 | Karrie Ann Stansfield | Pediatrics | 200 Arthur Dr, Thomasville, NC 27360-6275 | 2007-08-22 |
| Find all providers in THOMASVILLE | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
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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.