Hailey Dominy Stack, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12635 Issued in GA

Practice address

6413 Waters Ave Ste 102
Savannah, GA 31406-2711

Phone

(912) 349-6624

Fax

(912) 352-4728

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Internal Medicine of Savannah, LLCGroup PAC ID 2466614425, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
• Candler Hospital Hospital, Savannah, GA, CCN 110024

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EACIBA/Endpoint/EACIBA

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.

• Internal Medicine of Savannah, LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1346514114
  Medicare reassignment Care Compare group
• Margaret Ellis, MD, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Savannah, GA
  • NPI 1275022907
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Savannah Health Services, LLC

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1033736764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6413 WATERS AVE STE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062711",
            "telephone_number": "912-349-6624",
            "fax_number": "912-352-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 WATERS AVE STE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062711",
            "telephone_number": "912-349-6624",
            "fax_number": "912-352-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "HAILEY",
        "middle_name": "DOMINY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Joseph'S/Candler OB/GYN Practice, LLC
• Wendy St. Myers, PSY.D.
• St.Joseph'S/Candler Hospital
• Benjamin Mathew Stabbe, DC
• Stable Steps Your Behavior and Mental Health Provider LLC
• Karlye Stackhouse
• Shannon Stafford
• Mary Stallings, PAC
• Sydney Lauryn Stallings
• Alexandria Stanaland, LPC

• Physician Assistant in Savannah, GA
• Providers in Savannah, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.