Staci Avery Wood, RN

Primary specialty

Maternal Newborn Registered NurseTaxonomy code 163WM0102X

License

188963 Issued in NC

Practice address

20 Durham St
Southport, NC 28461-9327

Phone

(910) 305-1532

NPI assigned

Jun 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1073824660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DURHAM ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619327",
            "telephone_number": "910-305-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DURHAM ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619327",
            "telephone_number": "910-305-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "STACI",
        "middle_name": "AVERY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "NC",
            "license": "188963",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NC",
            "license": "188963",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "NC",
            "license": "188963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Douglas Wilson, MD
• Harrietthall Hall Witherspoon, COTA/L
• Womack Army Medical Center (Occ HLTH NSG Off-Sunny Point)
• Douglas Erick Wood, PTA
• Karen E Wood, MD
• Michael Wright
• Nadine Yamusah, MD
• Ye Olde Shoppe LLC (The Apothecary at St James)
• Teresa F Young, RPH
• Robert M Zukoski, M.D.

• Maternal Newborn Registered Nurse in Southport, NC
• Providers in Southport, NC by specialty
• Maternal Newborn Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.