Individual provider Active NPI

Stacy-Ann Wayne, MD

  • Child & Adolescent Psychiatry Physician
  • Richmond, VA
National Provider Identifier
1376047787
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
0101274642 Issued in VA
Practice address
1308 Sherwood Ave
Richmond, VA 23220-1210
Phone
(804) 828-3129
Fax
(804) 628-1236
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 0101274642 VA Primary

Addresses

Primary practice location

1308 Sherwood Ave
Richmond, VA 23220-1210

Mailing address

PO Box 780125
Philadelphia, PA 19178-0125
Phone (048) 283-1298

Other practice location 1

1945 State Route 33 # Rosa122
Neptune, NJ 07753-4859
Phone (732) 776-3712

Other practice location 2

1200 E Broad St
Richmond, VA 23298-5025
Phone (804) 628-9346

Other practice location 3

2924 Brook Rd
Richmond, VA 23220-1215
Phone (804) 628-9346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20240117000669 VA Practitioner - Psychiatry 6103220090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1308 Sherwood Ave
Richmond, VA 23220-1210
Phone (804) 828-3129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Dec 9, 2023 Accepting new patients

Locations

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1200 E Broad St
Richmond, VA 23298
Phone (804) 828-0970

1308 Sherwood Ave
Richmond, VA 23220
Phone (804) 828-3129

2924 Brook Rd
Richmond, VA 23220
Phone (804) 321-7474

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1376047787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "048-283-1298",
            "fax_number": "804-628-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 SHERWOOD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201210",
            "telephone_number": "804-828-3129",
            "fax_number": "804-628-1236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 State Route 33 # Rosa122",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-776-3712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985025",
            "country_code": "US",
            "telephone_number": "804-628-9346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2924 Brook Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232201215",
            "country_code": "US",
            "telephone_number": "804-628-9346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "STACY-ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101274642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.