Active NPI
Stacy N Knutson, PA-C
- Physician Assistant
- Biloxi, MS
National Provider Identifier
1063731032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00553
- Practice address
- 301 Fisher St
Biloxi, MS 39534-2508 - Phone
- (228) 376-0429
- NPI assigned
- May 28, 2010
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00553 | MS | Primary |
Addresses
Primary practice location
301 Fisher St
Biloxi, MS 39534-2508
Mailing address
301 Fisher St
Biloxi, MS 39534-2508
Phone (228) 376-0429
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1098239 | Other | NCCPA |
Other names 1
- Miss Stacy N Thornton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1340 Broad Ave
Gulfport, MS 39501-2460
1340 Broad Ave
Gulfport, MS 39501-2465
2781 C T Switzer Sr Dr
Biloxi, MS 39531-4535
4300 Leisure Time Dr
Diamondhead, MS 39525-3241
Phone (228) 255-4300
Hospital & facility affiliations
- Mississippi Homecare of Picayune
- Memorial Hospital at Gulfport
- Ochsner Medical Center-Hancock
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00553 | MS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients |
Locations
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
Organizations & group practices 3
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.
-
- Urology Physician
- Gulfport, MS
- NPI 1093142598
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
Hospital & facility affiliations 62
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1063731032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "BILOXI",
"state": "MS",
"postal_code": "395342508",
"telephone_number": "228-376-0429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 FISHER ST",
"city": "BILOXI",
"state": "MS",
"postal_code": "395342508",
"telephone_number": "228-376-0429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "STACY",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MS",
"license": "PA00553",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA",
"identifier": "1098239",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STACY",
"last_name": "THORNTON",
"middle_name": "N",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.
- 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.