Individual provider Active NPI

Lisa R Stuckey, PA-C

  • Medical Physician Assistant
  • Kinsley, KS
National Provider Identifier
1255529012
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1501228 Issued in KS
Practice address
620 W 8TH St
Kinsley, KS 67547-2329
Phone
(620) 659-3621
Fax
(620) 659-3810
NPI assigned
Oct 5, 2007
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1501228 KS Primary

Addresses

Primary practice location

620 W 8TH St
Kinsley, KS 67547-2329

Mailing address

PO Box 99
Kinsley, KS 67547-0099
Phone (620) 659-3651

Other practice location 1

205 Hall St
Spearville, KS 67876-8553
Phone (620) 385-2963

Other practice location 2

604 W 8th St
Kinsley, KS 67547-2329
Phone (620) 659-2732

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mdowler@edcomed.com Direct
Direct Messaging Address tstrate@edcomed.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000610 KS Practitioner - Physician Assistant 4385715234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 Hall St
Spearville, KS 67876-8553
Phone (620) 385-2963

604 W 8TH St
Kinsley, KS 67547-2329
Phone (620) 659-2732

620 W 8TH St
Kinsley, KS 67547-2329
Phone (620) 659-3621

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1501228KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards County Hospital and Healthcare Center CurrentSince Aug 1, 2012 Accepting new patients
Edwards County Hospital and Healthcare Center Current Accepting new patients
Edwards County Hospital and Healthcare Center CurrentSince Aug 1, 2012 Accepting new patients

Locations

604 W 8th St
Kinsley, KS 67547
Phone (620) 659-2732

Interoperability endpoints

  • Direct secure messaging: lisa.stuckey.p1@direct.edcomed.nextgenshare.com
  • Direct secure messaging: lisa.stuckey@khindirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1255529012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675470099",
            "telephone_number": "620-659-3651",
            "fax_number": "620-659-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W 8TH ST",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675472329",
            "telephone_number": "620-659-3621",
            "fax_number": "620-659-3810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Hall St",
            "address_purpose": "LOCATION",
            "city": "Spearville",
            "state": "KS",
            "postal_code": "678768553",
            "country_code": "US",
            "telephone_number": "620-385-2963",
            "fax_number": "620-385-2811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "604 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Kinsley",
            "state": "KS",
            "postal_code": "675472329",
            "country_code": "US",
            "telephone_number": "620-659-2732",
            "fax_number": "620-659-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1501228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdowler@edcomed.com",
            "affiliation": "N",
            "endpointDescription": "RHC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "620 W 8th St",
            "city": "Kinsley",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675472329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tstrate@edcomed.com",
            "affiliation": "N",
            "endpointDescription": "RHC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "620 W 8th St",
            "city": "Kinsley",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675472329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kinsley, KS

Sources for this page

Verify at the official NPI Registry.