Susan Brown Stavinoha, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01664 Issued in TX

Practice address

313 E 12TH St
Ste 104
Austin, TX 78701-1954

Phone

(512) 324-7000

NPI assigned

Jan 17, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8363/brand/2/csg/1/fhir/r4

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.

• Surgeons Who Only Care for Kids, PA

  • Surgery Physician
  • Austin, TX
  • NPI 1144315383
  NPD (past)
• University of Texas Medical Branch, Austin Initiatives at Utmb

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1144393802
  NPD (past)
• Utmb Austin - Initiatives

  • Multi-Specialty Clinic/Center
  • Austin, TX
  • NPI 1427099506
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1295887420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 E 12TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011954",
            "telephone_number": "512-324-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 E 12TH ST",
            "address_2": "STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011954",
            "telephone_number": "512-324-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVINOHA",
        "first_name": "SUSAN",
        "middle_name": "BROWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182810503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "819N07",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer C Staudenmyer, PT
• Kori Stauffacher, MA, LPC
• Nicole Christine Stavinoha-Pettit, P.T.
• Donna Stavinoha, PT
• Shannon L. Stavinoha, PH.D.
• Staywell, PLLC
• John Steadman
• Christopher Alan Stearns, MD
• Cristi Stearns, LPC
• Angelica Stebbins

• Medical Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.