Active NPI
Lynn Annette Stegall, PA-C
- Surgical Physician Assistant
- Memphis, TN
National Provider Identifier
1083617930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 462
- Practice address
- 6286 Briarcrest Ave
Suite 200
Memphis, TN 38120-4023 - Phone
- (901) 259-1600
- Fax
- (901) 259-2785
- NPI assigned
- May 24, 2005
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 462 | TN | Primary |
Addresses
Primary practice location
6286 Briarcrest Ave
Suite 200
Memphis, TN 38120-4023
Mailing address
PO Box 8888
Belfast, ME 04915-8888
Phone (901) 259-4260
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620819926 | Other | MS | BCBS |
| 620819926 | Other | TN | AETNA |
| 3662313 | Medicaid | TN | |
| 3371161 | Medicaid | TN | |
| 620819926 | Other | TN | CIGNA |
| 4087060 | Other | TN | BCBS |
| 110318002 | Medicaid | AR | |
| 7187860 | Medicaid | MS | |
| P00152990 | Other | TN | RAILROAD MEDICARE |
| 4113352 | Other | TN | BCBS |
| 620819926 | Other | TN | TRICARE |
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MSK Group, PC | Surgical | Past | Accepting new patients |
| MSK Group, PC | Past | Accepting new patients | |
| MSK Group PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272499200000",
"number": "1083617930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8888",
"city": "BELFAST",
"state": "ME",
"postal_code": "049158888",
"telephone_number": "901-259-4260",
"fax_number": "901-259-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6286 BRIARCREST AVE",
"address_2": "SUITE 200",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381204023",
"telephone_number": "901-259-1600",
"fax_number": "901-259-2785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEGALL",
"first_name": "LYNN",
"middle_name": "ANNETTE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-24",
"last_updated": "2010-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TN",
"license": "462",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "620819926",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "620819926",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3662313",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3371161",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "620819926",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4087060",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110318002",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7187860",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00152990",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4113352",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "620819926",
"state": "TN"
}
],
"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 Apr 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.