Stacy L Slaughter, PSY. D.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1015 S Broadway Ste 18
Minot, ND 58701-4667

Phone

(701) 857-8500

Fax

(701) 857-8555

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Stacy L Fuller Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1356473409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500",
            "fax_number": "701-857-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500",
            "fax_number": "701-857-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAUGHTER",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "404",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "029122",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054517",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "FULLER",
            "middle_name": "L",
            "credential": "PSY. D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Katie Skarda, RDN, LRD
• Anna Skarphol
• Dusty Amos Slagle
• Thomas Slagle
• Lisa Slater, PT, DPT
• Samantha J Slavik, LAC
• Lindsay M Sluder
• Amber Smith, MS, ATC
• Annaka Smith
• Benjamin Eli Smith, LAPC

• Case Manager/Care Coordinator in Minot, ND
• Providers in Minot, ND by specialty
• Case Manager/Care Coordinator in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.