Nicholas Emory Stallard

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

2917 Bella Vista Dr
Midwest City, OK 73110-4103

Phone

(405) 479-3056

NPI assigned

Apr 9, 2024

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1336992213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 BELLA VISTA DR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104103",
            "telephone_number": "405-479-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 BELLA VISTA DR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104103",
            "telephone_number": "405-479-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLARD",
        "first_name": "NICHOLAS",
        "middle_name": "EMORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SSM Health Care of Oklahoma, Inc
• SSM Health Care of Oklahoma, Inc
• SSM Health Care of Oklahoma, Inc (St Anthony Heritage Family Medicine)
• St Anthony Physicians Dermatology Midwest City (Saints Medical Group, LLC)
• Amber Stachmus, P.A.
• Monica Stanfield
• Heather D Stanley, APRN-CNP
• Michaela Elizabeth Starega, PTA
• Johnnie Lee Stark, DDS
• Robert Stark

• Peer Specialist in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.