Stacey Darrisaw, RN, CCM

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

RN124631 Issued in GA

Practice address

2020 7TH Ave
Columbus, GA 31904-8914

Phone

(762) 822-1242

Fax

(706) 494-4445

NPI assigned

May 12, 2020

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": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1104448281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WESTWOOD WAY",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318086069",
            "telephone_number": "762-822-1242",
            "fax_number": "706-494-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 7TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048914",
            "telephone_number": "762-822-1242",
            "fax_number": "706-494-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARRISAW",
        "first_name": "STACEY",
        "credential": "RN, CCM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "RN124631",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": "RN124631",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "RN124631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brelynn Daquilla
• Troy Darby
• Wendy Darby
• Lela Kristine Dark, CRNP
• Shane B Darrah, M.D.
• Monica Shyrell Darty, NP-C
• Raymond Dasilva, PHARM D
• Data House Transition Home
• Tamba Dauda, PHARM.D
• Kurt Jay Dauenhauer

• Case Management Agency in Columbus, GA
• Providers in Columbus, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.