STACEY T SHEPHERD (NPI# 1679673255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679673255 |
| Entity Type | Individual |
| Full Name | STACEY T SHEPHERD |
| Credential | PA-C |
| Practice Address |
5645 Stone Rd Centreville VA 20120-1618 |
| Mailing Address |
6705 Jackpin Pl Gainesville VA 20155-4459 |
| Practice Telephone | 7032662442 |
| Practice Fax Number | 7032667158 |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110001525 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780166686 | Stacey Jo Shepherd | Registered Nurse | 3000 N I 35, Denton, TX 76201-5119 | 2018-09-06 |
| 1134448244 | Stacey Shepherd | Occupational Therapist | 3221 Fruitville Rd, Sarasota, FL 34237-6452 | 2010-05-28 |
| Street Address |
5645 STONE RD |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20120-1618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484461 | Sandor Shawn Niemann | Family Medicine | 5645 Stone Rd, Centreville, VA 20120-1618 | 2005-08-19 |
| 1841821055 | Kiri Kelly Nye | Nurse Practitioner | 5645 Stone Rd, Centreville, VA 20120-1618 | 2020-01-28 |
| 1104278514 | Leah Zimmerman | Nurse Practitioner | 5645 Stone Rd, Centreville, VA 20120-1618 | 2016-07-09 |
| 1376934455 | Brenda Herrera | Family Medicine | 5645 Stone Rd, Centreville, VA 20120-1618 | 2015-02-11 |
| 1679981997 | Catrina Turner | Nurse Practitioner | 5645 Stone Rd, Centreville, VA 20120-1618 | 2014-07-30 |
| 1962843565 | Megan Anne Stuart | Nurse Practitioner | 5645 Stone Rd, Centreville, VA 20120-1618 | 2013-07-11 |
| 1124304936 | Abigail Crisman Ho | Nurse Practitioner | 5645 Stone Rd, Centreville, VA 20120-1618 | 2011-10-25 |
| 1417146663 | Solomon Mapeto Mutetwa | Family Medicine | 5645 Stone Rd, Centreville, VA 20120-1618 | 2007-10-23 |
| 1043234552 | Rocky Run Family Medicine Inc | Legal Medicine | 5645 Stone Rd, Centreville, VA 20120-1618 | 2006-07-27 |
| 1326009986 | Robert C Mancini | Family Medicine | 5645 Stone Rd, Centreville, VA 20120-1618 | 2006-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675477 | Happy Healthy Healing Pllc | Counselor | 5675 Stone Rd., Suite 310, Centreville, VA 20120 | 2019-05-21 |
| 1346725322 | Margo Flores Dds Pllc | Dentist | 5703 Centre Square Drive, Centreville, VA 20120 | 2018-09-26 |
| 1699274753 | Sarah Caitlin Brown | Nurse Practitioner | 5895 Trinity Pkwy Ste 100, Centreville, VA 20120 | 2018-02-05 |
| 1437687605 | Young Min Kim | Dentist | 5703 Centre Square Dr, Centreville, VA 20120 | 2017-05-31 |
| 1922349513 | Kristina Kallini | Social Worker | 13525 Leland Rd., Centreville, VA 20120 | 2013-03-07 |
| 1225209018 | About Care Obgyn Associates PC | Obstetrics & Gynecology | 6134 Redwood Square Center, Unit 101, Centreville, VA 20120 | 2008-03-19 |
| 1649486747 | Dulles Dental Group LLC | Dentist | 5103 Westfields Blvd, Centreville, VA 20120 | 2007-05-15 |
| 1356482657 | Kevin Michael Skinner | Dentist | 5651 Stone Rd, Centreville, VA 20120 | 2007-02-09 |
| 1952452856 | Jose Rodrigo Charcon | Physical Therapy Assistant | 5719 Centre Square Dr, Centreville, VA 20120 | 2007-01-16 |
| 1033122981 | Charles & Katherine Fischer Dds PC | Dentist | 5895 Trinity Parkway, Suite 200, Centreville, VA 20120 | 2006-08-14 |
| Find all providers in zip 20120 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134507734 | Eric Jividen | Physician Assistant | 13700 Crystalford Ct, Centreville, VA 20120-2085 | 2015-05-14 |
| 1619094158 | Story Mcdonald | Physician Assistant | 13880 Braddock Rd Ste 301, Centreville, VA 20121-2462 | 2007-03-22 |
| 1245685163 | Michelle Burton | Physician Assistant | 13880 Braddock Rd Ste 301, Centreville, VA 20121-2462 | 2016-04-28 |
| 1871965236 | Suzanne Ventress Tompkins | Physician Assistant | 405 Belcher St, Centreville, AL 35042-2946 | 2015-10-26 |
| 1578669610 | Gilda Loga | Physician Assistant | 6211 Centreville Rd, Suite 700, Centreville, VA 20121-2641 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124638986 | Courtney Anne Kassner | Physician Assistant | 2706 Davis Ave, Alexandria, VA 22302-2817 | 2020-08-06 |
| 1295356145 | Nilofar Ariasaif | Physician Assistant | 15401 Bald Eagle Ln, Woodbridge, VA 22191-3782 | 2020-05-01 |
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1902432644 | Madison Alexis Cooper | Physician Assistant | 920 Battlefield Blvd S Ste 101, Chesapeake, VA 23322-4254 | 2020-03-13 |
| 1285296111 | Kimberly Stewart Hugo | Physician Assistant | 10932 Point Grey Road, Henrico, VA 23233-2429 | 2019-07-01 |
| 1558824698 | Jessica Leigh Pacuch | Physician Assistant | 2440 Raphine Rd, Raphine, VA 24472-2541 | 2019-04-06 |
| 1073074431 | Nicholas Alexander Jones | Physician Assistant | 924 Parley Pl, Chesapeake, VA 23323-4135 | 2019-03-28 |
| 1003371410 | Ryan Timothy Pyles | Physician Assistant | 25 Commerce Park Drive, Raphine, VA 24472 | 2019-02-11 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 20120 |
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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.