Kelly A Stacy, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5432 Issued in SD

Practice address

640 Flormann St
Rapid City, SD 57701

Phone

(605) 718-3100

Fax

(605) 718-3426

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kstacy.12003@regionalhealth.sdhealthlink.net

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.

• Monument Health Rapid City Hospital, Inc

  dba Monument Health Behavioral Health Center

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment NPD
• Monument Health Rapid City Hospital Inc

  dba Monument Health Rapid Valley Clinic

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Monument Health Rapid City Hospital, Inc.

  dba Monument Health Wall Clinic

  • Family Medicine Physician
  • Wall, SD
  • NPI 1265811285
  NPD
• Medical Associates of the Black Hillc, LLC.

  • Pediatric Nurse Practitioner
  • Rapid City, SD
  • NPI 1871638072

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1265521009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-718-3100",
            "fax_number": "605-718-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "5432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mike Sprung
• Dawn R Sprunk, LMT
• Jennifer Jean Spurlock, BCBA
• Randy Leroy St.Pierre, AAS MLT (ASCP)
• Ashlynn Joy Stacey, RN
• Amber Victoria Staedtler, DNP AGNP-BC
• Jordan Marie Staedtler, M.S.ED CCC-SLP
• Patrick Staedtler
• Rebecca L Stafford, PA-C
• Edmund Jason Stamper, LPC-MH, QMHP, NCC

• Internal Medicine Physician in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Internal Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.