Active NPI
Stacy McKeegan, PTA
- Community Health Worker
- Memphis, TN
National Provider Identifier
1043467467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 3056
- Practice address
- 1076 Chambliss Rd
Memphis, TN 38116-6381 - Phone
- (901) 348-2273
- Fax
- (901) 345-8499
- NPI assigned
- Aug 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 3056 | TN | Primary |
Addresses
Primary practice location
1076 Chambliss Rd
Memphis, TN 38116-6381
Mailing address
7705 Lynx Run CV
Cordova, TN 38016-5700
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1043467467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7705 LYNX RUN CV",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380165700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1076 CHAMBLISS RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166381",
"telephone_number": "901-348-2273",
"fax_number": "901-345-8499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKEEGAN",
"first_name": "STACY",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "TN",
"license": "3056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.