Stacy Davis Moorman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30.020350 Issued in OH

Practice address

14062 US Highway 23
Suite B
Waverly, OH 45690-9415

Phone

(740) 947-1990

NPI assigned

Jul 26, 2005

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

Other identifiers 2

Other names 1

• Dr. Stacy Lynn Davis Professional name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stacy L Davis DDS Inc

  • General Practice Dentistry
  • Waverly, OH
  • NPI 1598466625
  NPD

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1295735892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14062 US HIGHWAY 23",
            "address_2": "SUITE B",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909415",
            "telephone_number": "740-947-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14062 US HIGHWAY 23",
            "address_2": "SUITE B",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909415",
            "telephone_number": "740-947-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "STACY",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "OH02350",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.020350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "803310",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0340634",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "DAVIS",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jenna Moore
• Jerri Dawn Moore
• Roger Moore
• Sarah Moore
• Tesa Moore, PTA
• Christy Moraleja
• Ahmed M Mosalem, M.D
• Heather Renee Mullins, CDCA
• Deanna Mundy
• Andrea Nicole Murray, BS, RN, CLC, ANLC

• Dentist in Waverly, OH
• Providers in Waverly, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.