Benjamin Robert Stacy, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2019-00320 Issued in NC

Practice address

1450 Fern Creek Dr
Statesville, NC 28625-9376

Phone

(704) 818-9191

Fax

(704) 872-3782

NPI assigned

May 21, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in NC, CO, UT3 enrollments

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 3

Specialty

Psychiatry

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations (25 of 33)

Interoperability endpoints

• Direct secure messaging: bstacy278463@direct.ochin.org

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.

• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215

  NC

  Medicare reassignment NPD
• Mindcare Solutions PC

  • Psychiatry Physician
  • Nashville, TN
  • NPI 1457015091

  CO, Psychiatry, UT

  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newton, NC
  • NPI 1023598570
  NPD
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1093127367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-818-9191",
            "fax_number": "704-872-3782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1703 Davie Ave",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286773521",
            "country_code": "US",
            "telephone_number": "704-818-9191",
            "fax_number": "704-862-5324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "518 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286774108",
            "country_code": "US",
            "telephone_number": "704-872-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACY",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2019-00320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SSC Brian Center Health and Rehabilitation
• SSC Statesville Brian Center Operating Company LLC
• SSC Statesville Maple Leaf Operating Company LLC
• Shayla Jenise St James
• Hannah Jean St. John, LCSWA
• Amy Stamper
• Adam Stapleton, PA-C
• Jessica Starr, ATC
• Statesville Amy Kinlaw PLLC
• Statesville Assisted Living

• All providers in Statesville, NC
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.

Verify at the official NPI Registry.