Stacey Mardis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35.121170 Issued in OH

Practice address

630 E River St
Department of Emergency Medicine
Elyria, OH 44035-5902

Phone

(440) 329-7450

NPI assigned

Jul 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Emergency Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Triad Physicians PLLCGroup PAC ID 6406197334, 37 clinicians

Tanglewood Park Physicians PLLCGroup PAC ID 3476895129, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Merit-based Incentive Payment System (MIPS)

Final score

89.09 of 100Reported as group

Quality

84.49

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.5 of 100Reported as group

Quality

84.11

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.02 of 100Reported as group

Quality

82.48

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Tanglewood Park Physicians, PLLC

  • Emergency Medicine Physician
  • Clemmons, NC
  • NPI 1093286379
  Medicare reassignment Care Compare group NPD
• Piedmont Triad Physicians, PLLC

  • Emergency Medicine Physician
  • Thomasville, NC
  • NPI 1295206464
  Medicare reassignment Care Compare group
• Brunswick Physician Partners, PLLC

  • Emergency Medicine Physician
  • Bolivia, NC
  • NPI 1457822264
  Medicare reassignment NPD
• Kernersville Emergency Group, PLLC

  • Emergency Medicine Physician
  • Kernersville, NC
  • NPI 1750852034
  Medicare reassignment NPD
• NC Emergency Physician Services, PLLC

  • Emergency Medicine Physician
  • Eden, NC
  • NPI 1518374800
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404
  Medicare reassignment NPD
• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205
  Medicare reassignment NPD
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment NPD
• Western Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Albemarle, NC
  • NPI 1134391758
  Medicare reassignment NPD
• Yadkin Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Elkin, NC
  • NPI 1417443771
  Medicare reassignment NPD
• Novant Health Thomasville Medical Center LLC

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1649159609
  NPD

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

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Novant Health Thomasville Medical Center, LLC

  • General Acute Care Hospital
  • Thomasville, NC
  • NPI 1801848767
  Care Compare affiliation

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1144532730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIS",
        "first_name": "STACEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.121170",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.121170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Latrice Manning
• Laura Manning
• Christine Mapus
• Marc Glassman Inc
• Kaiden Marcum
• Danielle Marie Markanich, CDCA
• Melissa Jane Marker, DO
• Steven Marks, BSCJ,CDCA
• Lara E Marsh, MD
• Laurel Marshall, DMD, MS

• Emergency Medicine Physician in Elyria, OH
• Providers in Elyria, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.