Jesse Ray Stafford, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

12067 Issued in SC

Practice address

8 Memorial Medical CT
Suite 1
Greenville, SC 29605-4455

Phone

(864) 295-3492

Fax

(864) 295-4817

NPI assigned

May 10, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1306896543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT",
            "address_2": "SUITE 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054455",
            "telephone_number": "864-295-3492",
            "fax_number": "864-295-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT",
            "address_2": "SUITE 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054455",
            "telephone_number": "864-295-3492",
            "fax_number": "864-295-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "JESSE",
        "middle_name": "RAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "SC",
            "license": "12067",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "12067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120672",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Francis Physician Services, Inc
• Doris M. Stabp, LISW-CP
• Kylie Kay Stacey
• Karen Sue Stacher, MD
• Jason Andrew Stack, D.M.D.
• Nikki S Stafford, OT
• Cynthia Stageberg
• Abbott Staggs
• Justine L Stahl, CNRA
• Jennifer Lee Stallworth, MS, CGC

• Anatomic Pathology & Clinical Pathology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Anatomic Pathology & Clinical Pathology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.