Stacy Gaillard

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

20150 Issued in SC

Practice address

109 W Main St
Moncks Corner, SC 29461-2673

Phone

(843) 719-4600

NPI assigned

Jan 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1285171694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FARMERS MARKET RD",
            "city": "SAINT GEORGE",
            "state": "SC",
            "postal_code": "294778290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612673",
            "telephone_number": "843-719-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILLARD",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "20150",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "20150",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "20150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Sue Frankeny, PA-C
• Takila L Frazier
• Leeann Fuerst, RN, BSN
• William Johnson Fuller, DPT
• Nytasia B Gaddist
• Jonathan H Garger, DMD
• Lashaun Rana Garrett-Fears, M.A.
• Crystal Jeanine Gaskins
• Autumn Sahmone Gathers, MA
• Lori B Gerding, MD

• Adult Health Nurse Practitioner in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.