RENNY STOCUM


Address: 46 Harrison St, Johnson City, NY 13790-2120
Phone: 6077294942

RENNY STOCUM (NPI# 1700096583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 007239 NY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 02499705 05

Office Location

Street Address 46 HARRISON ST
City JOHNSON CITY
State NY
Zip Code 13790-2120

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City JOHNSON CITY
Zip Code 13790

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Dataset Information

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.

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