Jennifer Michele Stall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

11835 State Route 9W
Emurgent Care
West Coxsackie, NY 12192-3605

Phone

(518) 731-9000

NPI assigned

Nov 19, 2010

Last updated

Feb 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1205138419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BEALE RD",
            "city": "CHATHAM",
            "state": "NY",
            "postal_code": "120372901",
            "telephone_number": "518-392-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 STATE ROUTE 9W",
            "address_2": "EMURGENT CARE",
            "city": "WEST COXSACKIE",
            "state": "NY",
            "postal_code": "121923605",
            "telephone_number": "518-731-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALL",
        "first_name": "JENNIFER",
        "middle_name": "MICHELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "MA",
            "license": "862889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack E. Redding II, PA-C
• Ethel Cabanas Rodgers, LMHC
• Brandon Smith, PA
• Erin Kimberly Smith I, DPT
• Alison H Spear, MD
• Jailene Stapleton, PA-C
• Kasparas Vilimas
• Daniel R Wiest, RPAC
• Konnor V Williams, PA-C
• Ann F Withjack, RPH

• Physician Assistant in West Coxsackie, NY
• Providers in West Coxsackie, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.