Shannon M Stacy, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A119069 Issued in CA

Practice address

3330 Lomita Blvd
Torrance Memorial Medical Center
Torrance, CA 90505-5002

Phone

(310) 325-9110

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

Yes

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 NC

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.

• Ecep II PA

  • Emergency Medicine Physician
  • Burgaw, NC
  • NPI 1255407680
  Medicare reassignment NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1558755165
  NPD
• Torrance Memorial Medical Center

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1740268713
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1043373087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "address_2": "TORRANCE MEMORIAL MEDICAL CENTER",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-325-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "address_2": "TORRANCE MEMORIAL MEDICAL CENTER",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-325-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A119069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwesi St. Louis, M.D
• Jarred Kyle M Sta Ana
• Valentino Stabile, RCP
• Claire Stacey
• Briana Stacy
• Stage of Life Counseling Inc
• Jennifer B. Stahl, D.P.T.
• Brittnae Amani Stallworth, PSYD.
• Melissa Stamant
• Emily Stanczak

• Emergency Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.