Active NPI
Stacy L Harbin, MD
- Surgery Physician
- Port St Joe, FL
National Provider Identifier
1275639254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME108578
- Practice address
- 3871 E Highway 98 Ste 200
Port St Joe, FL 32456-5302 - Phone
- (850) 229-5833
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 31761 | KY | |
| Surgery Physician | 208600000X | ME108578 | FL | Primary |
Addresses
Primary practice location
3871 E Highway 98 Ste 200
Port St Joe, FL 32456-5302
Mailing address
4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000329454 | Other | BCBS PROVIDER NUMBER | |
| 31761 | Other | KY | LICENSE |
| 64317613 | Medicaid | KY | |
| ME108578 | Other | FLORDIA MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- stacy.harbin.1@9582.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1275639254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 BELFORT RD STE 4015",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322163623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3871 E HIGHWAY 98 STE 200",
"city": "PORT ST JOE",
"state": "FL",
"postal_code": "324565302",
"telephone_number": "850-229-5833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARBIN",
"first_name": "STACY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "31761",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME108578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "000000329454",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "31761",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64317613",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORDIA MEDICAL LICENSE",
"identifier": "ME108578",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Port St Joe, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.