Individual provider Active NPI

Stacy King Slat, MD

  • Obstetrics & Gynecology Physician
  • Williamsburg, VA
National Provider Identifier
1144411422
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
48977 Issued in CT
Practice address
120 Kings Way Ste 3400
Williamsburg, VA 23185-2511
Phone
(757) 253-5600
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 48977 CT Primary

Addresses

Primary practice location

120 Kings Way Ste 3400
Williamsburg, VA 23185-2511

Mailing address

856 J Clyde Morris Blvd Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other practice location 1

77 Nealy Ave
Langley AFB, VA 23665-2040
Phone (757) 225-7630

Other names 1

  • Stacy Marie King Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181222000335 VA Practitioner - Obstetrics/Gynecology 5395080147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pennsylvania State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 668-3483

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48977CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evms Academic Physicians and Surgeons Health Services Foundation Obstetrics & Gynecology CurrentSince Feb 1, 2021 Accepting new patients
Riverside Physician Services Inc CurrentSince Dec 3, 2018 Accepting new patients
Riverside Physician Services, Inc. CurrentSince Dec 3, 2018 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients

Locations

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

120 Kings Way
Ste 3400
Williamsburg, VA 23185
Phone (757) 253-0819

3700 Battery Blvd
Ste 300
Williamsburg, VA 23185
Phone (757) 253-5600

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1144411422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY STE 3400",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852511",
            "telephone_number": "757-253-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Nealy Ave",
            "address_purpose": "LOCATION",
            "city": "Langley AFB",
            "state": "VA",
            "postal_code": "236652040",
            "country_code": "US",
            "telephone_number": "757-225-7630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAT",
        "first_name": "STACY",
        "middle_name": "KING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "48977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "KING",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.