Individual provider Active NPI

Lou Ann M. McStay, M.D.

  • Family Medicine Physician
  • Council Bluffs, IA
National Provider Identifier
1306957394
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20500 Issued in NE
Practice address
715 Harmony St
2ND Floor
Council Bluffs, IA 51503-3147
Phone
(712) 328-8500
NPI assigned
Aug 31, 2006
Last updated
Jan 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20500 NE Primary

Addresses

Primary practice location

715 Harmony St
2ND Floor
Council Bluffs, IA 51503-3147

Mailing address

PO Box 642117
Omaha, NE 68164-8117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190311002501 TX Practitioner - Family Practice 3072660174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20500NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1306957394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HARMONY ST",
            "address_2": "2ND FLOOR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033147",
            "telephone_number": "712-328-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSTAY",
        "first_name": "LOU ANN",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.