Stacy Emmanuel Richardson (NPI# 1891968293, PAC ID# 1850430943) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ANESTHESIOLOGY.
| Nation Provider ID (NPI) | 1891968293 |
| PAC ID by PECOS | 1850430943 |
| Professional Enrollment ID | I20091202000732 |
| Full Name | Stacy Emmanuel Richardson |
| Organization Legal Name | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Address |
4800 E Johnson Ave Jonesboro AR 72401-8413 |
| Phone Number | 8709361000 |
| Gender | M |
| Medical School | PIKEVILLE COLLEGE SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | ANESTHESIOLOGY |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 2466364997 |
| Number of Group Practice Members | 226 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040118 | NEA BAPTIST MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 8709361000 | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| 4800 E Johnson Ave, Nea Baptist Memorial Hospital, Jonesboro, AR 72401-8413 | 8709361000 | NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. |
| Organization Legal Name | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Physicians | 252 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Mayer Romain Khafi | Emergency Medicine | Southeastern Emergency Physicians LLC | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 |
| Thomas C Damhoff | Emergency Medicine | Southeastern Emergency Physicians LLC | 727 Hospital Dr, Shelbyville, KY 40065-1660 |
| Daren William Cox | Emergency Medicine | Southeastern Emergency Physicians LLC | 990 Oak Ridge Turnpike, Oak Ridge, TN 37830-6976 |
| Andrew Hunter Wheeler | Emergency Medicine | Southeastern Emergency Physicians LLC | 456 Burnley Rd, Scottsville, KY 42164-6355 |
| Mary E Harkleroad | Family Medicine | Southeastern Emergency Physicians LLC | 1 Trillium Way, Corbin, KY 40701-8420 |
| Lamin Bangura | Family Medicine | Southeastern Emergency Physicians LLC | 1080 Ellington Pkwy, Lewisburg, TN 37091-2227 |
| William J Mcintyre | Emergency Medicine | Southeastern Emergency Physicians LLC | 55 Foundation Dr, Flemingsburg, KY 41041-9815 |
| Robert A Hill | Family Medicine | Southeastern Emergency Physicians LLC | 1260 University Ave, Sewanee, TN 37375-2303 |
| Shirley K Catron | Family Medicine | Southeastern Emergency Physicians LLC | 723 Old Burkesville Rd, Albany, KY 42602-1654 |
| James L Fritzsche | Emergency Medicine | Southeastern Emergency Physicians LLC | 9352 Park W Blvd, Knoxville, TN 37923-4325 |
| Street Address |
4800 E JOHNSON AVE |
| City | JONESBORO |
| State | AR |
| Zip | 72401-8413 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martin A Vaughn | Certified Registered Nurse Anesthetist (crna) | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Nea Baptist Memorial Hospital, Jonesboro, AR 72401-8413 |
| Jarryd A Dempsey | Physical Therapy | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Ernest James Mcclinton Iii | Emergency Medicine | Southeastern Emergency Physicians LLC | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Michael E Davison | Certified Registered Nurse Anesthetist (crna) | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Nea Baptist Memorial Hospital, Jonesboro, AR 72401-8413 |
| Oksana Redko | Anesthesiology | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Nea Baptist Memorial Hospital, Jonesboro, AR 72401-8413 |
| Laura A Ferguson | Certified Registered Nurse Anesthetist (crna) | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Nea Baptist Memorial Hospital, Jonesboro, AR 72401-8413 |
| Justin K Martin | Occupational Therapy | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Christopher M Bruno | Diagnostic Radiology | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Daniel A Craven Jr. | Diagnostic Radiology | Mid South Imaging and Therapeutics Pa | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Jacob Jones | Physical Therapy | Northeast Arkansas Clinic Charitable Foundation, Inc. | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lawrence W Gordon | Ophthalmology | Mid South Retina Associates, LLC | 820 E Matthews, E, Jonesboro, AR 72401 |
| Carl J Abraham Jr. | Infectious Disease | Doctors Health Group, Inc | 3637 B E Johnson Ave, St. Bernards First Care Hilltop, Jonesboro, AR 72401-1808 |
| Brookshield Laurent | Family Medicine | Doctors Health Group, Inc | 3637 B E Johnson Ave, St. Bernards First Care Hilltop, Jonesboro, AR 72401-1808 |
| Joy C Skaug | Emergency Medicine | Doctors Health Group, Inc | 3637 B E Johnson Ave, St. Bernards First Care Hilltop, Jonesboro, AR 72401-1808 |
| Megan L Moll | Optometry | Hilltop Eyecare Pllc | 3705 E Johnson Ave, Jonesboro, AR 72401-1858 |
| Jacob P Moll | Optometry | Hilltop Eyecare Pllc | 3705 E Johnson Ave, Jonesboro, AR 72401-1858 |
| Cristina L Shaw | Clinical Social Worker | St Bernards Hospital Inc | 2712 E Johnson, Jonesboro, AR 72401-1874 |
| Karen J Reinertsen | Psychiatry | St. Bernards Hospital Inc | 2712 E Johnson Ave, St Bernards Behav, Jonesboro, AR 72401-1874 |
| Eloise E Weeks | Psychiatry | St. Bernards Hospital Inc | 2712 E Johnson Ave, St Bernards Behav, Jonesboro, AR 72401-1874 |
| Lillian Somner | Psychiatry | St. Bernards Hospital Inc | 2712 E Johnson Ave, St Bernards Behav, Jonesboro, AR 72401-1874 |
| Find all physicians in zip 72401 | |||
| City | JONESBORO |
| Zip Code | 72401 |
| Specialty | ANESTHESIOLOGY |
| City + Specialty | JONESBORO + ANESTHESIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.