Joshua Stake, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R0331 Issued in TX

Practice address

1600 Providence Dr
Attn: Traci Mitchell- Admn
Waco, TX 76707-2261

Phone

(254) 313-4200

Fax

(254) 313-4326

NPI assigned

Jun 11, 2015

Last updated

Jan 13, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1407237894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "address_2": "ATTN: TRACI MITCHELL- ADMN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "address_2": "ATTN: TRACI MITCHELL- ADMN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKE",
        "first_name": "JOSHUA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R0331",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10054660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Weldon Stacey, DC
• Stacie L. Virden, O.D. P.a.
• Stacie Layne Virden OD PA
• Stacy L Lessman PA
• Devan Stahl
• Othniel Stanberry, OD
• Kelly Elizabeth Standley, COTA
• Ginger Stanfield
• Sue E. Stanko, MD
• Kelly Stanley, LCSW

• Family Medicine Physician in Waco, TX
• Providers in Waco, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.