STACEY M JOHNSON MD PA (NPI# 1831203512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831203512 |
| Entity Type | Organization |
| Organization Name | STACEY M JOHNSON MD PA |
| Other Organization Name | PHYSICIANS MEDICAL CENTER OF THE OZARKS |
| Practice Address |
# 17 Medical Plaza Mountain Home AR 72653 |
| Practice Telephone | 8704256212 |
| Practice Fax Number | 8704243774 |
| Mailing Telephone | 8704256212 |
| Mailing Fax Number | 8704243774 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-05-29 |
| Authorized Official Name | PETE ROSS (COO VP OF OPERATIONS) |
| Authorized Official Telephone | 8704256212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | R2724 | AR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 111814002 | 05 | |
| AR | AR BCBS PROV | 57598 | 01 |
| Other Name | Type Code |
|---|---|
| Physicians Medical Center of the Ozarks | Doing Business As Name - Organization |
| Street Address |
# 17 MEDICAL PLAZA |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639401946 | Pain Clinic of North Arkansas Pllc | Anesthesiology | # 17 Medical Plaza, Mountain Home, AR 72653 | 2010-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1073716569 | Bruce D. Robbins, M.d. | Specialist | 1422 Highway 62 W, Mountain Home, AR 72653-4617 | 2007-06-11 |
| 1831305556 | Perry L Wilbur Md Pa | Specialist | 505 Hospital Dr, Mountain Home, AR 72653-2912 | 2007-05-16 |
| 1134341381 | Bruce Wolf Physical Therapy, P.a. | Specialist | 607 Northtown, Mountain Home, AR 72653-3121 | 2007-05-03 |
| 1700918471 | Physical Therapy Connection, Inc. | Specialist | 1027 Highway 62 E, Mountain Home, AR 72653-3215 | 2007-03-09 |
| 1790855518 | Linda P Woodbury | Specialist | 1200 Highway 201 N, Mountain Home, AR 72653-2440 | 2006-11-09 |
| 1215961859 | R. Harber Wood | Specialist | James H. Quillen/vamc (johnson City), Corner of Veterans Way and Lamont, Mountain Home, TN 37684 | 2006-07-10 |
| 1962454355 | Richard R Reece | Specialist | Sidney & Lamont Streets, V. A. Medical Center, Mountain Home, TN 37684 | 2006-05-16 |
| 1285602292 | Bruce Donald Robbins | Specialist | 1422 Hwy 62 Sw, Mountain Home, AR 72653-4617 | 2006-03-08 |
| 1114993060 | Louis Woodrow Elkins Jr. | Specialist | 628 Hospital Dr Ste 3-e, Mountain Home, AR 72653-2937 | 2006-02-28 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on STACEY M JOHNSON MD PA.
| 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.