JACKIE P. STAFFORD (NPI# 1609150622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609150622 |
| Entity Type | Individual |
| Full Name | JACKIE P. STAFFORD |
| Credential | DNP |
| Practice Address |
710 Chesterfield Hwy Cheraw SC 29520-7001 |
| Mailing Address |
Po Box 3239 Florence SC 29502-3239 |
| Practice Telephone | 8435372171 |
| Practice Fax Number | 8435375926 |
| Mailing Telephone | 8437777098 |
| Mailing Fax Number | 8437777102 |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2017-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
17625 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP1947 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568763019 | Jackie Dee Stafford | Family Medicine | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2010-11-14 |
| Street Address |
710 CHESTERFIELD HWY |
| City | CHERAW |
| State | SC |
| Zip Code | 29520-7001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598768830 | Thomas Vincent Distefano | Orthopaedic Surgery | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2005-05-31 |
| 1306470448 | Mcleod Occupational Health, LLC | Preventive Medicine | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2020-02-27 |
| 1649818253 | Mcleod Health Cheraw | Clinic/Center | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2019-12-13 |
| 1326509324 | Eric Mclaine | Family Medicine | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2019-03-31 |
| 1942710009 | Miranda Renee Gainey | Nurse Practitioner | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2017-10-03 |
| 1063956704 | Holly Byrd Copeland | Nurse Practitioner | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2016-12-15 |
| 1073960654 | Mcleod Physician Associates II | Orthopaedic Surgery | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2016-05-24 |
| 1518349158 | Garrett Barton | Family Medicine | 710 Chesterfield Hwy, Cheraw, SC 29520 | 2015-06-19 |
| 1346632817 | Mcleod Physician Associates II | Family Medicine | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2015-02-20 |
| 1942629944 | Patricia N. Moore | Nurse Practitioner | 710 Chesterfield Hwy, Cheraw, SC 29520-7001 | 2014-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811541824 | Gloria Curtis | Nurse's Aide | 2912 Wire 1 Rd, Cheraw, SC 29520 | 2019-07-29 |
| 1427419175 | New Perspective Life Center LLC | Case Management | 319 Chesterfiled Hwy #9, Cheraw, SC 29520 | 2016-03-09 |
| 1306203310 | Highly Favored LLC | Counselor | 65 Sanders Ln, Cheraw, SC 29520 | 2016-01-21 |
| 1962880690 | Butterfly Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1562 Fred Davis Road, Cheraw, SC 29520 | 2015-05-14 |
| 1912304387 | Wrights Care Services LLC | Community/Behavioral Health | 319 East Chesterfield Hwy, Cheraw, SC 29520 | 2014-12-01 |
| 1386994762 | Stefanie Deese | Pharmacist | 901 Market St., Cheraw, SC 29520 | 2012-09-13 |
| 1699952218 | Chesterfield Marlboro, Lp | General Acute Care Hospital | Highway 9 West, Cheraw, SC 29520 | 2008-01-25 |
| 1174678411 | Carolina Eye Associates, Inc. | Ophthalmology | 705 Chesterfield Hwy, Cheraw, SC 29520 | 2007-01-25 |
| 1619030855 | Horton Chiropractic Clinic of Cheraw, Pa | Chiropractor | 601 Diane Dr, Cheraw, SC 29520 | 2006-12-19 |
| 1700947835 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 104 Grace Lane, Cheraw, SC 29520 | 2006-12-13 |
| Find all providers in zip 29520 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497137533 | Sarah Knight | Nurse Practitioner | 715 S Doctors Dr, Ste. A,b,d,e, Cheraw, SC 29520-7113 | 2015-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898038 | Latoya Gibson | Nurse Practitioner | 48 Centennial Way, Greenville, SC 29605-4662 | 2020-10-12 |
| 1003413469 | South Carolina Provider Services | Nurse Practitioner | 413 Wildflower Rd, Easley, SC 29642-8642 | 2020-10-07 |
| 1578173555 | Amy Kelly | Nurse Practitioner | 115 N Sumter St Ste 300, Sumter, SC 29150-4967 | 2020-08-05 |
| 1588293278 | Kimberly Dianne Billie Jackson | Nurse Practitioner | 940 Morningside Dr, Sumter, SC 29153-7724 | 2020-04-04 |
| 1427696475 | Porscha Rush | Nurse Practitioner | 1040 Frye Rd, Galivants Ferry, SC 29544-8018 | 2019-12-19 |
| 1306483011 | Julie Marie Sim | Nurse Practitioner | 35 Bill Fries Dr Bldg F, Hilton Head Island, SC 29926-2731 | 2019-12-02 |
| 1144780909 | Chantal Pilar Debreceny | Nurse Practitioner | 1167 Basketweave Drive, #204, Mount Pleasant, SC 29466 | 2019-03-20 |
| 1396225769 | Kristin Claude | Nurse Practitioner | 421 Se Main St Ste 100, Simpsonville, SC 29681-2697 | 2018-08-15 |
| 1376031732 | Migina Anica Timpson | Nurse Practitioner | 317 Saint Francis Dr Ste 220, Greenville, SC 29601-3976 | 2018-05-01 |
| 1932601903 | Jamie Andrews Odom | Nurse Practitioner | 2720 Sunset Blvd Ste 300, West Columbia, SC 29169-4810 | 2018-03-06 |
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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.