Jackie R Stines Jr., MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

24389 Issued in WV

Practice address

1600 Medical Center Drive
Ste 3500
Huntington, WV 25701

Phone

(304) 691-1300

Fax

(304) 691-1375

NPI assigned

May 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Physicians & Surgeons, Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1730183286

  Pediatrics

  Medicare reassignment NPD
• University Physicians & Surgeons, Inc.

  • Health & Wellness Coach
  • Louisa, KY
  • NPI 1073256665
  NPD

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1023222197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DRIVE",
            "address_2": "STE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DRIVE",
            "address_2": "STE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINES",
        "first_name": "JACKIE",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "24389",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WV",
            "license": "24389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jack.stines@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Drive",
            "address_2": "Ste 3500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Stickler, M.D.
• Sailor Miles Stickler, DO
• Vanessa Nicole Stidham
• Whitney Stidham, APRN
• Patricia Nicole Stillwell, FNP-C
• Michael S. Stinnett, PSYD
• John Stock, R.PH.
• Richard E Stocker Jr., PTA
• Rebecca Gail Stokes, NP
• Erica Nicole Stoler, MA ED.S

• Pediatric Cardiology Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Pediatric Cardiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.