Stacey Dotson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2019015945 Issued in MO

Practice address

203 N Grand St
Salem, MO 65560-1344

Phone

(573) 729-4103

NPI assigned

Aug 27, 2019

Last updated

Aug 27, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Missouri Behavioral Health Inc

  • Community/Behavioral Health Agency
  • Farmington, MO
  • NPI 1982875407
  NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1083262893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N GRAND ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N GRAND ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601344",
            "telephone_number": "573-729-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "STACEY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2019015945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Demorlis, MD
• Dent County Developmental Disabilities Board
• Dent County Health Center
• Lisa Dewitt, RN
• Elizabeth Rachelle Dillon, RN
• Amber Nicole Duncan, D.C
• Amy Sue Dunn, BCBA, LBA, PLPC
• Crystal Dzindolet, LPN
• Jason Edwards, LICENSED DIETITIAN
• Ellis Chiropractic Clinic, LLC (Ellis Health Centre)

• Registered Nurse in Salem, MO
• Providers in Salem, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.