Shannon Stafford

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

73192 Issued in SC

Practice address

10125 Dorchester Rd Ste A7
Summerville, SC 29485-8548

Phone

(843) 520-9934

NPI assigned

Dec 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1093301103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BEN RUFUS DR",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294408753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 DORCHESTER RD STE A7",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858548",
            "telephone_number": "843-520-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "SC",
            "license": "73192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "yahoo.com",
            "affiliation": "N",
            "endpointDescription": "secure emails",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure emails",
            "address_1": "10125 Dorchester Rd Ste A7",
            "city": "Summerville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294858548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Natalie Nicole Stanley
• Gabrielle Stapf
• Star, LLC

• Prosthetics Case Management in Summerville, SC
• Providers in Summerville, SC by specialty
• Prosthetics Case Management in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.