Stacy M Dodd, R.N

Key facts

NPI

1154711273

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

4704310558 (MI)

Practice address

20340 195TH Ave
Big Rapids, MI 49307-9398

Phone

(231) 408-7491

NPI assigned

Jan 27, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 27, 2015.

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1154711273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20340 195TH AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079398",
            "telephone_number": "231-408-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20340 195TH AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079398",
            "telephone_number": "231-408-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "R.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704310558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

• Melissa Ann Deniel, M.D.
• Gail A Desnoyers, MD
• Sarah Marie Devries, OD
• James Ryan Dietrick, D.C.
• Amy Elaine Dinardo, O.D.
• Toni Marie Dodge, RNC-OB, C-EFM, NP-BC
• Kendra Lee Dolorfino, CPNP
• Jenna Lynn Dotson
• Julie Ann Doyle
• DRS Nevins Family Dentistry PC

All providers in Big Rapids, MI · Registered Nurse in Michigan