Stacy Boone, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TX PA 00217 Issued in TX

Practice address

4802 N Loop 289
Lubbock, TX 79416-3025

Phone

(806) 788-0040

Fax

(806) 788-0015

NPI assigned

Nov 21, 2005

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: stacy.boone.1@24018.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.

• Texas Physicians Group

  • Cardiovascular Disease Physician
  • Lubbock, TX
  • NPI 1497014369
  Medicare reassignment

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1326021734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040",
            "fax_number": "806-788-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040",
            "fax_number": "806-788-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "STACY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "TX PA 00217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Franklin Bookout, M.D.
• Judith Alison Boomer, PA
• Matthew Lewis Boomer
• Timothy Lewis Boomer, PA-C
• Amy M Boone, SLP-ASSISTANT
• Boonipat Craniofacial and Facial Plastic Surgery (Boonipat Facial Plastic Surgery)
• James Jeffrey Boop, M.D.
• Rachael Booth
• Kandis Wright Boothe, MD, PHD
• William David Boothe, M.D.

• Physician Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.