Individual provider Active NPI

Stacy A Homan, CSFA/CST

  • Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1003470428
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
156449 Issued in OH
Practice address
3333 Burnet Ave
Cincinnati, OH 45229-3039
Phone
(513) 636-4200
NPI assigned
May 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 156449 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
Cincinnati, OH 45229-3039

Mailing address

3333 Burnet Ave
Cincinnati, OH 45229-3026

Other names 1

  • Stacy A Homan-Carter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
156449OHMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1003470428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "STACY",
        "middle_name": "A",
        "credential": "CSFA/CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "156449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HOMAN-CARTER",
            "middle_name": "A",
            "credential": "CSFA/CST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.