Individual provider Active NPI

Stacy-Ann Preddie, LABORATORY DIRECTOR

  • Phlebotomy Technician
  • Coral Springs, FL
National Provider Identifier
1194301358
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Practice address
7857 W Sample Rd Ste 136
Coral Springs, FL 33065-4748
Phone
(954) 225-5224
NPI assigned
Mar 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X Primary

Addresses

Primary practice location

7857 W Sample Rd Ste 136
Coral Springs, FL 33065-4748

Mailing address

7857 W Sample Rd Ste 136
Coral Springs, FL 33065-4748
Phone (954) 225-5224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Diagnostics Solutions LLC CurrentSince Mar 28, 2021 Accepting new patients

Locations

7857 W Sample Rd
Ste 136
Coral Springs, FL 33065
Phone (954) 225-5224

Organizations & group practices 1

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": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1194301358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7857 W SAMPLE RD STE 136",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654748",
            "telephone_number": "954-225-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7857 W SAMPLE RD STE 136",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654748",
            "telephone_number": "954-225-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDDIE",
        "first_name": "STACY-ANN",
        "credential": "LABORATORY DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.