STACY WAYNE SLADE (NPI# 1669996567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669996567 |
| Entity Type | Individual |
| Full Name | STACY WAYNE SLADE |
| Credential | PA-C |
| Practice Address |
4475 S Eastern Ave Las Vegas NV 89119-7826 |
| Mailing Address |
7150 W Sunset Rd Ste 201a Las Vegas NV 89113-1981 |
| Practice Telephone | 7026695840 |
| Mailing Telephone | 7023161622 |
| Mailing Fax Number | 7029510782 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2018-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1852 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | SMA MEDICARE | V52094 | 01 |
| NV | 1669996567 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265459267 | Stacy N Slade | Physician Assistant | 1225 W Front St, Traverse City, MI 49684-2368 | 2006-07-16 |
| Street Address |
4475 S EASTERN AVE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-7826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245232750 | Paul Parcon | Family Medicine | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2005-08-15 |
| 1073114906 | Jacob A Parks | Student in an Organized Health Care Education/Training Program | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2020-11-06 |
| 1649871567 | Spencer Fleek | Student in an Organized Health Care Education/Training Program | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2020-11-06 |
| 1245831338 | Lauren Belove | Student in an Organized Health Care Education/Training Program | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2020-11-04 |
| 1396201414 | Robin Suzanne Branham | Nurse Practitioner | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2019-02-13 |
| 1558838136 | Daniel Thane Winward | Physician Assistant | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2018-10-31 |
| 1588189021 | Sandra Ramsey | Nurse Practitioner | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2017-08-05 |
| 1992236145 | Scarlett Cavalli | Family Medicine | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2017-03-21 |
| 1619418472 | Cameron Hunter | Physician Assistant | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2017-03-13 |
| 1568917425 | Michael Christian Swart | Physician Assistant | 4475 S Eastern Ave, Las Vegas, NV 89119-7826 | 2016-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | [email protected], 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| 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 |
|---|---|---|---|---|
| 1376165985 | Vanessa E R Pulido Artienda | Physician Assistant | 7829 Strong Water Ct, Las Vegas, NV 89131-8247 | 2020-05-18 |
| 1427697952 | Fabiola Capano | Physician Assistant | 6930 S Cimarron Rd Ste 260, Las Vegas, NV 89113-2135 | 2020-01-01 |
| 1588200521 | Kimberly Hunt | Physician Assistant | 2250 E Flamingo Rd Ste 100, Las Vegas, NV 89119-5170 | 2019-11-25 |
| 1104461433 | Jacqueline Emilia Lindine | Physician Assistant | 7720 W Sahara Ave Ste 103, Las Vegas, NV 89117-2754 | 2019-11-11 |
| 1255973285 | Kirstey Langston | Physician Assistant | 4475 S Eastern Ave Ste 1500, Las Vegas, NV 89119-7826 | 2019-10-10 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1548825094 | Victoria Ashlyn James Hinton | Physician Assistant | 5775 S Fort Apache Rd Ste 120, Las Vegas, NV 89148-5627 | 2019-05-09 |
| 1275007205 | Kathy Ann Tran | Physician Assistant | 401 N Buffalo Dr Ste 200, Las Vegas, NV 89145-0397 | 2019-01-12 |
| 1144717067 | Lynne Barbara Ulevich | Physician Assistant | 9310 S Eastern Ave Ste 122, Las Vegas, NV 89123-6844 | 2018-04-16 |
| 1104326727 | Amanda Howe Parker Bartlett | Physician Assistant | 7170 Smoke Ranch Rd Ste 110, Las Vegas, NV 89128-3208 | 2018-02-20 |
| Find all providers in LAS VEGAS | ||||
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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.