Active NPI
Jimmy Dee Stanley, PA-C
- Medical Physician Assistant
- San Antonio, TX
National Provider Identifier
1144402264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 1100 Wilford Hall Loop
San Antonio, TX 78236-5638 - Phone
- (210) 292-3866
- NPI assigned
- Nov 30, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop
San Antonio, TX 78236-5638
Mailing address
1100 Wilford Hall Loop
San Antonio, TX 78236-5638
Phone (210) 292-3866
Other practice location 1
6900 Alden Dr
Fe Warren AFB, WY 82005-2945
Phone (307) 773-3525
Other practice location 2
2864 Woodruff Street
Bldg 2-1959
Fort Bragg, NC 28390
Phone (910) 570-3393
Other practice location 3
Unit 2060
Apo, AP 96278-2060
Phone (505) 784-8717
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1144402264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-3866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-3866"
}
],
"practiceLocations": [
{
"address_1": "6900 Alden Dr",
"address_purpose": "LOCATION",
"city": "Fe Warren AFB",
"state": "WY",
"postal_code": "820052945",
"country_code": "US",
"telephone_number": "307-773-3525",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2864 Woodruff Street",
"address_2": "Bldg 2-1959",
"address_purpose": "LOCATION",
"city": "Fort Bragg",
"state": "NC",
"postal_code": "28390",
"country_code": "US",
"telephone_number": "910-570-3393",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Unit 2060",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "962782060",
"country_code": "US",
"telephone_number": "505-784-8717",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "STANLEY",
"first_name": "JIMMY",
"middle_name": "DEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-30",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.