STACEY EPPERSON MOFFITT (NPI# 1447294582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447294582 |
| Entity Type | Individual |
| Full Name | STACEY EPPERSON MOFFITT |
| Credential | PA |
| Practice Address |
701 University Blvd E Ste 606 Tuscaloosa AL 35401-7411 |
| Practice Telephone | 2057522501 |
| Practice Fax Number | 2057595874 |
| Mailing Telephone | 2057522501 |
| Mailing Fax Number | 2057595874 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA.264 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-264 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS BLUE SHIELD | 51504089 | 01 |
| AL | 051504089 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 305 Paul Bryant Dr E, Tuscaloosa, AL 354012094 | 2053450192 | 2052472194 |
| Street Address |
701 UNIVERSITY BLVD E STE 606 |
| City | TUSCALOOSA |
| State | AL |
| Zip Code | 35401-7411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124313556 | Grayson William Menard | Surgery | 701 University Blvd E Ste 606, Tuscaloosa, AL 35401 | 2011-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942768031 | Serenity and Hope LLC | Clinic/Center | 2703 7th Street, Tuscaloosa, AL 35401 | 2019-03-07 |
| 1356834428 | Heather Glenn Macleod | Social Worker | 303 Hargrove Rd E Ste A, Tuscaloosa, AL 35401 | 2018-06-12 |
| 1154832921 | Imc of Alabama | Physical Therapist | 5101 21st Street, Tuscaloosa, AL 35401 | 2017-10-19 |
| 1316466238 | Parents Resource Institute for Drug Education (pride) of Tuscaloosa | Community/Behavioral Health | 620 14th Street, Suite E, Tuscaloosa, AL 35401 | 2017-09-12 |
| 1871967075 | Jeri Zemke | Specialist/Technologist | 504 University Blvd, Tuscaloosa, AL 35401 | 2015-11-25 |
| 1356719033 | Jimmy Dean Winters | Nurse Practitioner | Five Horizons Health Services, 2720 6th Street, Tuscaloosa, AL 35401 | 2015-09-11 |
| 1831505429 | Jennifer Baggett | Speech-Language Pathologist | 603 Hackberry Lane, Tuscaloosa, AL 35401 | 2014-07-03 |
| 1184045684 | Samantha Pasteur | Massage Therapist | 2601 12 St, Tuscaloosa, AL 35401 | 2013-12-31 |
| 1386089282 | John Logan Bailey | Pharmacist | 809 University Boulevard, Dch Regional Medical Center, Tuscaloosa, AL 35401 | 2013-05-06 |
| 1104170539 | Kristin C Townsend | Technician, Other | 500 -b Paul Bryant Drive East, Tuscaloosa, AL 35401 | 2012-11-07 |
| Find all providers in zip 35401 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134223365 | Kristi Martin Whitaker | Physician Assistant | 305 Paul Bryant Drive E, Tuscaloosa, AL 35401-2094 | 2006-09-08 |
| 1962418988 | James Cecil Labresh | Physician Assistant | 701 University Blvd E Ste 808, Tuscaloosa, AL 35401-7433 | 2006-07-31 |
| 1437505138 | Jaime Petrosky | Physician Assistant | 701 University Blvd E, Suite 606, Tuscaloosa, AL 35401-2086 | 2016-05-11 |
| 1922346071 | Catherine Elizabeth Beckham | Physician Assistant | 305 Paul W Bryant Dr E, Tuscaloosa, AL 35401-2055 | 2013-01-24 |
| 1740467794 | Lauren Hobart Wise | Physician Assistant | 305 Paul Bryant Drive E, Tuscaloosa, AL 35403-2055 | 2008-01-22 |
| 1063440386 | Ann Roby Mcdonald | Physician Assistant | 701 University Blvd E, Suite 808, Tuscaloosa, AL 35401 | 2006-06-28 |
| 1093759805 | Hugh Randall Latham | Physician Assistant | 305 Paul Bryant Dr E, Tuscaloosa, AL 35401-2094 | 2006-06-15 |
| 1629018411 | Carla R Randolph | Physician Assistant | 305 Paul Bryant Dr E, Tuscaloosa, AL 35401-2094 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942771183 | Sarah Elizabeth Sloop | Physician Assistant | 4300 W Main St Ste 24, Dothan, AL 36305-1312 | 2018-12-16 |
| 1053887885 | Rachel B Rigsby | Physician Assistant | 22454 Us Highway 72 Ste 200, Athens, AL 35613-2609 | 2018-10-19 |
| 1588139349 | Lauren M Sheffield | Physician Assistant | 22454 Hwy 72, Suite 200, Athens, AL 35613 | 2018-10-09 |
| 1255815908 | Cora Kuhns | Physician Assistant | 6401 Jordan Rd Suite A, Daphne, AL 36526-4728 | 2018-09-19 |
| 1396282026 | Travis Blackburn | Physician Assistant | 200 Montgomery Hwy Ste 125, Vestavia, AL 35216-1840 | 2017-01-19 |
| 1043603236 | Julie Boyd | Physician Assistant | 516 20th St S, Birmingham, AL 35233-2028 | 2015-03-11 |
| 1255738605 | James Cilimberg | Physician Assistant | 2871 Acton Rd, Suite 100, Vestavia, AL 35243-2559 | 2014-12-01 |
| 1780950733 | Laura Nugent Bradley | Physician Assistant | 800 St. Vincent's Drive, Suite 700, Birmingham, AL 35205-1630 | 2012-03-23 |
| 1740583780 | University Orthopaedic Clinic, PC | Physician Assistant | 1732 Temple Ave N, Fayette, AL 35555-1321 | 2010-12-14 |
| 1811290968 | Lacey Golden | Physician Assistant | 48 Medical Park Dr E Ste 255, Birmingham, AL 35235-3464 | 2010-12-13 |
| Find all providers with the same taxonomy | ||||
| City | TUSCALOOSA |
| Zip Code | 35401 |
Please comment or provide details below to improve the information on STACEY EPPERSON MOFFITT.
| 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.