Stacy L MC Dowell, CNS

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

71003872A Issued in IN

Practice address

621 Memorial Dr Ste 312
South Bend, IN 46601-1073

Phone

(574) 647-5200

Fax

(574) 647-5210

NPI assigned

Dec 1, 2010

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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.

• Radiology, Inc

  • Diagnostic Radiology Physician
  • Mishawaka, IN
  • NPI 1578557815
  NPD (past)

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1376845073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 312",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011073",
            "telephone_number": "574-647-5200",
            "fax_number": "574-647-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC DOWELL",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IN",
            "license": "71003872A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG VASCULAR INTERVENTIONAL RAD",
            "identifier": "000000769085",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201006430",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01146029",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Maxwell, PH.D.
• Carol L Mayernick, LMHC
• Cynthia E Mayfield, MD
• Bradley S Mazick, PHD,HSPP
• Jackline Wangui Mburu
• Kevin Jeremy McAward, M.D.
• Rochelle McBean, MSW
• Kelly McBurney, RBT
• Cassandra McCammon
• Hailey McCann

• Clinical Nurse Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.