STACY L MC DOWELL (NPI# 1376845073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376845073 |
Entity Type | Individual |
Full Name | STACY L MC DOWELL |
Credential | CNS |
Practice Address |
621 Memorial Dr Ste 312 South Bend IN 46601-1073 |
Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
Practice Telephone | 5746475200 |
Practice Fax Number | 5746475210 |
Mailing Telephone | 5746471610 |
Enumeration Date | 2010-12-01 |
Last Update Date | 2018-04-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364S00000X | Clinical Nurse Specialist | 71003872A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | RR MEDICARE | P01146029 | 01 |
IN | BCBS BMG VASCULAR INTERVENTIONAL RAD | 000000769085 | 01 |
IN | 201006430 | 05 |
Street Address |
621 MEMORIAL DR STE 312 |
City | SOUTH BEND |
State | IN |
Zip Code | 46601-1073 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801881255 | Howard Elvindo Wiarda | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601 | 2005-09-13 |
1124671813 | Amanda Ann Aldana | Nurse Practitioner | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2019-07-22 |
1932468352 | Beacon Medical Group, Inc. | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2012-05-04 |
1689669715 | Kevin M Small | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2005-09-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
Find all providers in zip 46601 |
Taxonomy Code | 364S00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235653908 | Amanda J Blanton | Clinical Nurse Specialist | 350 W Columbia St Ste 350, Evansville, IN 47710-5610 | 2017-08-03 |
1144657123 | Tanya May Clary | Clinical Nurse Specialist | 11725 N. Illinois St, Suite 350, Carmel, IN 46032-3009 | 2013-10-04 |
1205117454 | Deanna L. Massie | Clinical Nurse Specialist | 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804-4159 | 2011-09-01 |
1851471221 | Margaret Rose Payne | Clinical Nurse Specialist | 850 N Meridian St, 2nd Floor, Indianapolis, IN 46204-1098 | 2006-10-17 |
1720090947 | Kimberly Mellencamp Freeman | Clinical Nurse Specialist | 2325 18th St, Suite 210, Columbus, IN 47201-5388 | 2006-08-13 |
1710944863 | Penni Lorraine Cremer | Clinical Nurse Specialist | 1424 E 91st St, Indianapolis, IN 46240-1902 | 2006-05-01 |
1902864036 | Karen E. Hughes | Clinical Nurse Specialist | 1345 Unity Pl Ste 135, Lafayette, IN 47905 | 2006-05-01 |
1558978353 | Ann Allison | Clinical Nurse Specialist | 1111 Ronald Reagan Pkwy, Avon, IN 46123-7085 | 2020-09-25 |
1518592278 | Ivy Rynearson | Clinical Nurse Specialist | 1345 Unity Pl Ste 355, Lafayette, IN 47905-5761 | 2020-03-03 |
1568019354 | Deaconess Hospital, Inc | Clinical Nurse Specialist | 4111 Gateway Blvd, Newburgh, IN 47630-8954 | 2019-08-26 |
Find all providers with the same taxonomy |
City | SOUTH BEND |
Zip Code | 46601 |
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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.