Amy White Stafford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.A10510 Issued in LA

Practice address

9007 Ellerbe Rd
Shreveport, LA 71106-6724

Phone

(318) 222-3278

Fax

(318) 424-3155

NPI assigned

May 30, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Surgery ApmcGroup PAC ID 5294627683, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: astafford@dermatologyskinsurgery.emadirect.md

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.

• Dermatology and Skin Surgery Apmc

  • Dermatology Physician
  • Shreveport, LA
  • NPI 1023005758

  LA

  Medicare reassignment Care Compare group
• Advanced Cardiovascular Specialists

  • Cardiovascular Disease Physician
  • Shreveport, LA
  • NPI 1881127090
  NPD (past)
• Ark-la-Tex Cardiology, Apmc

  • Cardiovascular Disease Physician
  • Shreveport, LA
  • NPI 1497745921
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704499200000",
    "number": "1386845964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066724",
            "telephone_number": "318-222-3278",
            "fax_number": "318-424-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9007 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066724",
            "telephone_number": "318-222-3278",
            "fax_number": "318-424-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "AMY",
        "middle_name": "WHITE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.A10510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529044",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Matthew'S Direct Care Service
• St. Matthew'S Direct Care Service
• William Staab
• Thomas E Staats, PHD
• Lori A Stackow, PAC
• Christina Danielle Stafford
• John E Stafford, DDS
• Paul R Stafford, MD
• Renalda Stafford
• Adam Christopher Stage, M.D.

• All providers in Shreveport, LA
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.