Individual provider Active NPI

Stacy Lynn Prescott, MD

  • Emergency Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1184615494
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2014-0253 Issued in NM
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 298-2551
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G79689 CA
Emergency Medicine Physician 207P00000X 44622 CO
Emergency Medicine Physician 207P00000X MD2014-0253 NM Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2551

Other identifiers 2

IdentifierTypeStateIssuer
0G796890MedicaidCA
00G796890OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, WA, AZ, MO, TX5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20141105001630 NM Practitioner - Emergency Medicine 4981668530 Reassigns benefits to 3 organizations
I20160330001394 WA Practitioner - Emergency Medicine 4981668530 Reassigns benefits to 1 organization
I20160512000537 AZ Practitioner - Emergency Medicine 4981668530 Reassigns benefits to 2 organizations
I20170512001425 MO Practitioner - Emergency Medicine 4981668530
I20200720003361 TX Practitioner - Emergency Medicine 4981668530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79689CAMDEmergency Medicine Physician
44622COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tempe Emergency Physicians, LTD Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Alteon Health New Mexico LLC Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
Las Cruces HB Medical Services LLC Emergency Medicine CurrentSince Sep 24, 2023 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince Mar 17, 2023 Accepting new patients
Tempe Emergency Physicians, LTD Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Colorado West Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
San Francisco Emergency Medical Associates Emergency Medicine Past Accepting new patients
Pegasus Emergency Group Wyoming LLC Emergency Medicine Past Accepting new patients
Hartwell Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Hartwell Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

2200 S Houghton Rd
Tucson, AZ 85748
Phone (520) 287-5728

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

2811 N Main St
Las Cruces, NM 88001
Phone (575) 526-0080

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

Interoperability endpoints

  • Direct secure messaging: sprescott177691@ahs.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1184615494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G79689",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "44622",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2014-0253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0G796890",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G796890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.