Stacey South (NPI# 1336368547, PAC ID# 5799752721) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GYNECOLOGICAL ONCOLOGY.
| Nation Provider ID (NPI) | 1336368547 |
| PAC ID by PECOS | 5799752721 |
| Professional Enrollment ID | I20080930000114 |
| Full Name | Stacey South |
| Organization Legal Name | FWC GYN ONCOLOGY LLC |
| Address |
5315 4th Ave Cir E Bradenton FL 34208-5623 |
| Phone Number | 9417467507 |
| Gender | F |
| Credential | MD |
| Medical School | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | GYNECOLOGICAL ONCOLOGY |
| Group Practice PAC ID | 7113187352 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100035 | MANATEE MEMORIAL HOSPITAL |
| 100166 | DOCTORS HOSPITAL OF SARASOTA |
| 100087 | SARASOTA MEMORIAL HOSPITAL |
| 100299 | LAKEWOOD RANCH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 5315 4th Ave Cir E, Bradenton, FL 34208-5623 | 9417467507 | FWC GYN ONCOLOGY LLC |
| 3425 University Pkwy, Unit 102, Sarasota, FL 34243-4271 | 9417467507 | FWC GYN ONCOLOGY LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | FWC GYN ONCOLOGY LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen S Taylor | Nurse Practitioner | Fwc Gyn Oncology LLC | 5315 4th Ave Cir E, Bradenton, FL 34208-5623 |
| Street Address |
5315 4TH AVE CIR E |
| City | BRADENTON |
| State | FL |
| Zip | 34208-5623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen S Taylor | Nurse Practitioner | Fwc Gyn Oncology LLC | 5315 4th Ave Cir E, Bradenton, FL 34208-5623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sabrina Baker | Nurse Practitioner | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Bijal J Patel | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Michelle G Green | Nurse Practitioner | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Cassandra M. Hafner | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Ashley Metzgar | Physician Assistant | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Catherine Mauldin Cooper | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| James M Pineno | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Christopher M Cooper | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Natalie E Borg | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Andrew R Clark | Family Medicine | Cooper Family Medical Pllc | 5123 4th Ave Cir E, Bradenton, FL 34208 |
| Find all physicians in zip 34208 | |||
| City | BRADENTON |
| Zip Code | 34208 |
| Specialty | GYNECOLOGICAL ONCOLOGY |
| City + Specialty | BRADENTON + GYNECOLOGICAL ONCOLOGY |
Please comment or provide details below to improve the information on Stacey South.
| 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.