Individual provider Active NPI

Stacey Lynn Poznanski, DO

  • Emergency Medicine Physician
  • Kettering, OH
National Provider Identifier
1063569879
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
009855 Issued in OH
Practice address
3525 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-8839
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 51684 WI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 009855 OH Primary

Addresses

Primary practice location

3525 Southern Blvd
Kettering, OH 45429-1221

Mailing address

9387 Paragon Mills LN
Centerville, OH 45458-4185
Phone (608) 770-6005

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 2

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 3

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 4

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 5

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 6

450 Washington Jackson Rd Ste F
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 7

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other practice location 8

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other identifiers 1

IdentifierTypeStateIssuer
3069003MedicaidOH

Other names 1

  • Dr. Stacey Lynn Brand Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20101007000099 OH Practitioner - Emergency Medicine 6800088048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists IncGroup PAC ID 7315851359, 111 clinicians

Practice addresses (Care Compare)

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 702-4024

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
009855OHMDEmergency Medicine Physician
51684WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists, Inc Emergency Medicine CurrentSince Aug 10, 2010 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Current Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine CurrentSince Aug 10, 2010 Accepting new patients
Samaritan Emergency Corp Emergency Medicine Past Accepting new patients

Locations

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

450 Washington Jackson Rd
#F
Eaton, OH 45320
Phone (937) 456-8376

100 Kettering Way
Franklin, OH 45005
Phone (937) 458-4700

8701 Troy Pike
Huber Heights, OH 45424
Phone (937) 558-3309

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

3131 Newmark Dr
Ste 220
Miamisburg, OH 45342

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

6147 State Route 122
Middletown, OH 45005
Phone (513) 261-3410

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1063569879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9387 PARAGON MILLS LN",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584185",
            "telephone_number": "608-770-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "fax_number": "937-458-4737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "fax_number": "513-261-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "fax_number": "937-401-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "fax_number": "937-558-3349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "fax_number": "937-456-8377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "fax_number": "937-723-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "fax_number": "937-384-8729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POZNANSKI",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "51684",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "009855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069003",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BRAND",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.