STACY L MC DOWELL


Address: 621 Memorial Dr Ste 312, South Bend, IN 46601-1073
Phone: 5746475200

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364S00000X Clinical Nurse Specialist 71003872A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN RR MEDICARE P01146029 01
IN BCBS BMG VASCULAR INTERVENTIONAL RAD 000000769085 01
IN 201006430 05

Office Location

Street Address 621 MEMORIAL DR STE 312
City SOUTH BEND
State IN
Zip Code 46601-1073

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 364S00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist

Taxonomy Definition

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.

Providers in the same taxonomy and state

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
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Competitor

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City SOUTH BEND
Zip Code 46601

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Dataset Information

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.

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