MS. STACEY TILLMAN SUTTLES (NPI# 1578826681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578826681 |
| Entity Type | Individual |
| Full Name | MS. STACEY TILLMAN SUTTLES |
| Credential | PA-C |
| Practice Address |
Bld 681, 1st Floor Schofield Barracks HI 96857 |
| Mailing Address |
Usarmy Health Clinics Schofield Barracks Bld 683, Attn: Fns Bld 681, Rm 126 Schofield Barracks HI 96857 |
| Practice Telephone | 8084338475 |
| Mailing Telephone | 8084338475 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2019-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
BLD 681, 1ST FLOOR |
| City | SCHOFIELD BARRACKS |
| State | HI |
| Zip Code | 96857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114542529 | Susan H. Greenia | Marriage & Family Therapist | 673 Ayres Ave, Bdlg 750 Room 136, Schofield Barracks, HI 96857 | 2020-06-11 |
| 1528688215 | Angelika Koreen-gordon | Registered Nurse | Desmond T. Doss Health Clinic, Bldg 682, Schofield Barracks, HI 96857 | 2020-04-22 |
| 1841822863 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Schofield Main Exchange Building, 694 Mccornack Suite Sac19, Schofield Barracks, HI 96857 | 2020-02-07 |
| 1972152528 | Andrea D Raskin | Dental Hygienist | Bldg 660 Mc Cornack Road, Schofield Barracks, HI 96857 | 2019-09-06 |
| 1376190959 | Nicole Felice Bishop | Dental Hygienist | Bldg#678 Mccornack Road, Na Koa Dental Clinic, Schofield Barracks, HI 96857 | 2019-08-20 |
| 1134648728 | Fiorela Ruiz | Social Worker | 471 Brannon Rd. Bldg. 96857, Schofield Barracks, HI 96857 | 2017-09-14 |
| 1821512245 | Jennifer Jo Witt | Nurse Practitioner | 394 Glennan St., Bldg 672 Room 217, Schofield Barracks, HI 96857 | 2017-07-27 |
| 1154842847 | Tracey Lynne Ross | Physical Therapy Assistant | 371 Brannon Road, Building 663, Schofield Barracks, HI 96857 | 2017-07-03 |
| 1205388279 | Amber Marks | Physician Assistant | Us Army Healthcare Clinic, Bldg 677, Schofield Barracks, HI 96857 | 2016-10-26 |
| 1144616442 | Rocky L. Cole | Counselor | 2094 Flagler Rd, Rm. 203a, Schofield Barracks, HI 96857 | 2015-04-13 |
| Find all providers in zip 96857 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245720564 | Zi Xiang Liu | Physician Assistant | 3399 Glennan Street, Schofield Barracks, HI 96786 | 2018-05-11 |
| 1982121059 | Salvador Mireles Thorn | Physician Assistant | U.S. Army Health Clinic Sb, Building 683, Schofield Barracks, HI 96786 | 2017-08-29 |
| 1205388279 | Amber Marks | Physician Assistant | Us Army Healthcare Clinic, Bldg 677, Schofield Barracks, HI 96857 | 2016-10-26 |
| 1669898086 | Bernard Toney Jr. | Physician Assistant | 683 Waianae Avenue, U.S. Army Health Clinic-schofield Barracks, Schofield Barracks, HI 96786 | 2014-03-10 |
| 1225459902 | Eva Fremaint | Physician Assistant | Building 678, Schofield Barracks Health Clinic, Combat Aviation Bde, Schofield Barracks, HI 96786 | 2013-12-23 |
| 1336452556 | Paul E Whelan | Physician Assistant | Building 677, 2-27 Inf 3rd Bde 25 Id, Schofield Barracks, HI 96786 | 2010-07-16 |
| 1821115734 | Susanna Estaniqui | Physician Assistant | Us Army Health Clinic, Bldg 683, Schofield Barracks, HI 96786 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433505 | Jessica Renae Hall | Physician Assistant | 201 Bougainvillea Loop, Honolulu, HI 96818-1495 | 2020-10-08 |
| 1508472085 | Lauren Whitney Hall | Physician Assistant | 91-1368 Kaileolea Dr, Ewa Beach, HI 96706-6289 | 2020-09-19 |
| 1568076685 | Emily Rose Callaway | Physician Assistant | 501 Hahaione St Apt 8j, Honolulu, HI 96825-1444 | 2020-09-04 |
| 1053939124 | Jamie Tamayose | Physician Assistant | 46-1063 Emepela Way Apt 6u, Kaneohe, HI 96744-3940 | 2020-07-06 |
| 1982161782 | Amanda Laurent | Physician Assistant | 1401 S Beretania St Ste 102, Honolulu, HI 96814-1871 | 2019-02-28 |
| 1720578693 | Ashley Marie Mccall | Physician Assistant | 900 Fort Street Mall Ste 1040, Honolulu, HI 96813-3701 | 2018-05-15 |
| 1902300056 | Hawaii Care Connect Medical Group LLC | Physician Assistant | 94-356 Waipahu Depot St Ste 204, Waipahu, HI 96797-3057 | 2018-03-22 |
| 1154835353 | Arthur Burgos Domingo | Physician Assistant | 445 Seaside Ave, Honolulu, HI 96815-2640 | 2017-11-27 |
| 1467975219 | Suwimon Thammarossopon | Physician Assistant | 683 Wahiawa, Us Army Health Clinic Schofield Barracks, Wahiawa, HI 96786 | 2017-07-24 |
| 1720528565 | Kathryn Elizabeth Cosgrove | Physician Assistant | 46-001 Kamehameha Hwy Ste 107, Kaneohe, HI 96744-3720 | 2017-02-27 |
| Find all providers with the same taxonomy | ||||
| City | SCHOFIELD BARRACKS |
| Zip Code | 96857 |
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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.