Stacey Harris Tadlock (NPI# 1639684848, PAC ID# 4981967122) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1639684848 |
| PAC ID by PECOS | 4981967122 |
| Professional Enrollment ID | I20180420001880 |
| Full Name | Stacey Harris Tadlock |
| Organization Legal Name | SENTARA MEDICAL GROUP |
| Address |
3000 Coliseum Dr Suite 200 Hampton VA 23666-5963 |
| Phone Number | 7577367250 |
| Gender | F |
| Medical School | UNIVERSITY OF MIAMI SCHOOL OF MEDICINE |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8921903923 |
| Number of Group Practice Members | 848 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490093 | SENTARA CAREPLEX HOSPITAL |
| 490007 | SENTARA NORFOLK GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3000 Coliseum Dr, Suite 200, Hampton, VA 23666-5963 | 7577367250 | SENTARA MEDICAL GROUP |
| Organization Legal Name | SENTARA MEDICAL GROUP |
| Physicians | 866 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Merrilyn E Nelson | Family Medicine | Sentara Medical Group | 2859 Virginia Beach Blvd, Virginia Beach, VA 23452-7613 |
| Natalia Zapata | Nurse Practitioner | Sentara Medical Group | 303 35th St, Suite 102, Virginia Beach, VA 23451-2868 |
| Meredith Constance Galt | Physician Assistant | Sentara Medical Group | 2017 Pleasure House Rd, Virginia Beach, VA 23455-2709 |
| Christopher Nein | Family Medicine | Sentara Medical Group | 3920 Bridge Rd A, Suffolk, VA 23435-1117 |
| Mary Townsend Adams | Nurse Practitioner | Sentara Medical Group | 3600 Pointe Ctr Ct, Dumfries, VA 22026-2669 |
| Laura Renee Pinkney | Nurse Practitioner | Sentara Medical Group | 3920 A Bridge Rd, Suite 207, Suffolk, VA 23435-1107 |
| Erica L Formato | Family Medicine | Sentara Medical Group | 2760 Godwin Blvd, Suite 100, Suffolk, VA 23434-8501 |
| Diane Renee Weidner | Nurse Practitioner | Sentara Medical Group | 500 Sentara Circle, Suite 202, Williamsburg, VA 23188-5727 |
| Julie Sharlene Jones | Nurse Practitioner | Sentara Medical Group | 633 Battlefield Blcd S, 300 Intracoastal Family Practice, Chesapeake, VA 23322-4800 |
| Martha I Morolari | Nurse Practitioner | Sentara Medical Group | 2025 Glenn Mitchell Dr, Virginia Beach, VA 23456-0178 |
| Street Address |
3000 COLISEUM DR SUITE 200 |
| City | HAMPTON |
| State | VA |
| Zip | 23666-5963 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Baogang J Xu | Diagnostic Radiology | Tidewater Diagnostic Imaging Ltd | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Dennis M Cruff | General Surgery | Sentara Medical Group | 3000 Coliseum Dr, Suite 200, Hampton, VA 23666-5963 |
| Sara Magdy Bouraee | Podiatry | Sara Bouraee LLC | 3000 Coliseum Dr, Suite 205, Hampton, VA 23666-5963 |
| Joshua Forrest Stephenson | Diagnostic Radiology | Tidewater Diagnostic Imaging Ltd | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Chadwick Mills | Diagnostic Radiology | Tidewater Diagnostic Imaging Ltd | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Mary Lydon Guye | Surgical Oncology | Sentara Medical Group | 3000 Coliseum Dr, Suite 200, Hampton, VA 23666-5963 |
| Matthew P Caldwell | Anesthesiology | Smg Anesthesia Specialists LLC | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Patricia K Robbins | Nurse Practitioner | Sentara Medical Group | 3000 Coliseum Dr, Suite 200, Hampton, VA 23666-5963 |
| Nirjhor Sayed Bhowmik | Diagnostic Radiology | Tidewater Diagnostic Imaging Ltd | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Richard L Toothman | Diagnostic Radiology | Tidewater Diagnostic Imaging Ltd | 3000 Coliseum Dr, Hampton, VA 23666-5963 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Henry L Rothfuss | Internal Medicine | 303 Butler Farm Rd, Suite 103, Hampton, VA 23666-1568 | |
| Tiffany N Jefferson | Clinical Social Worker | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| Melody Blanco | Nurse Practitioner | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| Charlena Cuffee | Clinical Social Worker | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| John D Ogram | Psychiatry | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| Lisa M Kelleher | Nurse Practitioner | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| Peter Smith | Psychiatry | Hampton Newport News Community Services Board | 200 Medical Dr A, Hampton, VA 23666-1763 |
| Saphia Beckles | Nurse Practitioner | Hampton Newport News Community Services Board | 400 Medical Dr A, Hampton, VA 23666-1767 |
| Brenda J Williams | Clinical Social Worker | Hampton Newport News Community Services Board | 400 Medical Dr A, Hampton, VA 23666-1767 |
| Ashraful Huq | Psychiatry | Hampton Newport News Community Services Board | 400 Medical Dr A, Hampton, VA 23666-1767 |
| Find all physicians in zip 23666 | |||
| City | HAMPTON |
| Zip Code | 23666 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | HAMPTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Stacey Harris Tadlock.
| 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.