Michael Lee Stack, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

28719 Issued in TN

Practice address

6215 Humphreys Blvd Ste 200
Memphis, TN 38120-2382

Phone

(901) 512-6086

Fax

(833) 450-5323

NPI assigned

Jun 23, 2005

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Obstetrics/Gynecology

Education

University of Tennessee, HSC, College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Tennessee LLCGroup PAC ID 0547667552, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstack30967@mlh.direct-ci.com
• Direct secure messaging: michael.stack@tn051.digichart.direct-ci.com
• Direct secure messaging: michael.stack.1@25094.direct.athenahealth.com

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.

• Privia Medical Group Tennessee LLC

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1376110858

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Bluff City OBGYN Association, PC

  dba Bluff City OBGYN Associates

  • Obstetrics & Gynecology Physician
  • Memphis, TN
  • NPI 1033977137
  NPD Authorized official
• Privia Medical Group Tennessee LLC

  dba Sports Ortho Urgent Care

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Nashville, TN
  • NPI 1215694229
  NPD
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  NPD (past)
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1316943301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202382",
            "telephone_number": "901-512-6086",
            "fax_number": "833-450-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202382",
            "telephone_number": "901-512-6086",
            "fax_number": "833-450-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7796 Wolf Trail Cv Ste 202",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381783",
            "country_code": "US",
            "telephone_number": "901-512-6086",
            "fax_number": "866-230-7816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "28719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00475770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4347596",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3840616",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy L St. Clair, NP
• St. Jude Children's Research Hospital Home Care, LLC
• St. Jude Childrens Research Hospital
• Bernetta St. Omer, BS
• Stacie a Arbor DDS PLLC
• Demetra Stackhouse-Powe, PHD, LMSW
• Kara Gwin Stacy
• Aileen Stadler
• Briana Stadler
• Megan Stafeil, NNP-BC

• Obstetrics & Gynecology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Obstetrics & Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.