RENNY STOCUM (NPI# 1700096583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700096583 |
Entity Type | Individual |
Full Name | RENNY STOCUM |
Credential | P.A. |
Practice Address |
46 Harrison St Johnson City NY 13790-2120 |
Mailing Address |
33 Lewis Rd 2nd Fl Binghamton NY 13905 |
Practice Telephone | 6077294942 |
Practice Fax Number | 6077297516 |
Mailing Telephone | 6077298156 |
Enumeration Date | 2007-05-23 |
Last Update Date | 2017-10-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 007239 | NY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 02499705 | 05 |
Street Address |
46 HARRISON ST |
City | JOHNSON CITY |
State | NY |
Zip Code | 13790-2120 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922085497 | Saeed Bajwa | Neurological Surgery | 46 Harrison St, Johnson City, NY 13790 | 2005-12-27 |
1174135305 | Milton Harding | Nurse Practitioner | 46 Harrison St, Johnson City, NY 13790-2120 | 2020-08-19 |
1265987325 | Upstate University Clinical Campus Medical Group At Binghamton, Inc. | Psychiatry & Neurology | 46 Harrison St, Johnson City, NY 13790-2120 | 2016-08-18 |
1821493263 | Oana Stingu | Physician Assistant | 46 Harrison St, Johnson City, NY 13790-2120 | 2014-10-28 |
1700297918 | Diana Rasmussen | Nurse Practitioner | 46 Harrison St, Southern New York Neurosurgical Group, P.C., Johnson City, NY 13790-2120 | 2014-05-12 |
1225058530 | Christine Snyder | Physician Assistant | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-07-20 |
1306866983 | Joseph Garrehy | Physician Assistant | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-07-19 |
1831115351 | Joseph Andusko | Physician Assistant | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-07-15 |
1932125788 | Southern New York Neurosurgical Group PC | Specialist | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-07-14 |
1053374835 | Barry J Pollack | Neurological Surgery | 46 Harrison St, Johnson City, NY 13790-2120 | 2006-04-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
Find all providers in zip 13790 |
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 |
---|---|---|---|---|
1821616590 | Brenda L Rankhorn | Physician Assistant | 402 Brookwood Dr, Johnson City, TN 37615-4924 | 2020-07-09 |
1336706183 | Andrew Thomas Rogers | Physician Assistant | 401 E Watauga Ave, Johnson City, TN 37601-4036 | 2019-05-28 |
1750859831 | Bethany Marie Zakrzewski | Physician Assistant | 410 N State of Franklin Rd Ste 120, Johnson City, TN 37604-6972 | 2018-11-07 |
1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
1417453440 | Blue Ridge Medical Management Corpoartion | Physician Assistant | 701 Med Tech Pkwy Ste 300, Johnson City, TN 37604-2365 | 2018-03-30 |
1083082838 | Amber Dykes | Physician Assistant | 119 Boone Ridge Dr Ste 201, Johnson City, TN 37615-8000 | 2015-09-10 |
1720336712 | Amy C Flint | Physician Assistant | 303 Med Tech Pkwy Ste 150, Johnson City, TN 37604-2394 | 2012-08-22 |
1568779155 | Tracy Mcwhorter Martino | Physician Assistant | 3 Professional Park Dr Ste 21, Johnson City, TN 37604-6529 | 2010-09-03 |
1932430741 | Lisa M Adams | Physician Assistant | 1301 Sunset Drive, Suite 3, Johnson City, TN 37604 | 2010-01-18 |
1265594618 | Whitney Diane Davis | Physician Assistant | 2514 Wesley St Ste 102, Johnson City, TN 37601-1764 | 2006-12-14 |
Find all providers in JOHNSON CITY |
City | JOHNSON CITY |
Zip Code | 13790 |
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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.