Stephanie A Lage, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9102148 Issued in FL

Practice address

2780 Cleveland Ave
Suite 819
Fort Myers, FL 33901-5858

Phone

(239) 343-3800

Fax

(239) 343-3993

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD (past)
• Orthopedic Specialists of SW Florida, P.a.

  • Orthopaedic Surgery Physician
  • Fort Myers, FL
  • NPI 1770410433
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1346230653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1400",
            "fax_number": "239-424-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CLEVELAND AVE",
            "address_2": "SUITE 819",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015858",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGE",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9102148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9102148",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna M Ladd, OTR
• Elizabeth Ladnyk, LMHC
• Sternson A Ladouceur, PT, DPT
• Emily Laeser, ARNP
• Keith Lafferty, MD
• Emely Lago
• Alex Leyon Lagodzinski, APRN, FNP-BC
• Robert George Anthony Laing
• Kelli Laird, LPN
• Lake Diabetes Supply, Inc

• Surgical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.