Active NPI
Staci B. Hodge, PA-C
- Physician Assistant
- Baltimore, MD
National Provider Identifier
1427249846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0003533
- Practice address
- 3333 N Calvert St
Suite 400
Baltimore, MD 21218-2867 - Phone
- (410) 554-4382
- Fax
- (410) 554-2084
- NPI assigned
- Aug 9, 2007
- Last updated
- Sep 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0003533 | MD | Primary |
Addresses
Primary practice location
3333 N Calvert St
Suite 400
Baltimore, MD 21218-2867
Mailing address
3333 North Calvert St
Gcoa
Baltimore, MD 21218
Phone (410) 554-4382
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0003533 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1427249846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 NORTH CALVERT ST",
"address_2": "GCOA",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21218",
"telephone_number": "410-554-4382",
"fax_number": "410-554-2084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 N CALVERT ST",
"address_2": "SUITE 400",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212182867",
"telephone_number": "410-554-4382",
"fax_number": "410-554-2084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "STACI",
"middle_name": "B.",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-09",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0003533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.