NPIMap

Organization Active NPI

Stacy Sisson

  • Technician
  • Saint Louis, MO
National Provider Identifier
1164550026
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
License
143216 Issued in MO
Legal business name
STACY SISSON
Practice address
5608 Cliff Cave Crossing Dr
Saint Louis, MO 63129-4368
Phone
(314) 960-0957
Fax
(314) 846-1161
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Mrs. Stacy J Sisson, R.N.NPI 1306972500
Title
Owner
Phone
(314) 960-0957

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 374700000X 143216 MO Primary

Addresses

Primary practice location

5608 Cliff Cave Crossing Dr
Saint Louis, MO 63129-4368

Mailing address

5608 Cliff Cave Crossing Dr
Saint Louis, MO 63129-4368
Phone (314) 960-0957

Other names 1

  • ProTec Labs Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1164550026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 CLIFF CAVE CROSSING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631294368",
            "telephone_number": "314-960-0957",
            "fax_number": "314-846-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5608 CLIFF CAVE CROSSING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631294368",
            "telephone_number": "314-960-0957",
            "fax_number": "314-846-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY SISSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SISSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-960-0957",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician",
            "state": "MO",
            "license": "143216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProTec Labs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.