Blake Alexander Stacey, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2023-01786 Issued in NC

Practice address

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494

Phone

(919) 736-1110

NPI assigned

Apr 21, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC, FL2 enrollments

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 2

Specialty

Emergency Medicine

Education

University of Florida College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Emergency Physicians LLCGroup PAC ID 2668368952, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bstacey356295@directhisp.wakemed.org
• Direct secure messaging: bstacey726147@direct.unc.nchie.net

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.

• Bay Area Emergency Physicians LLC

  • Emergency Medicine Physician
  • Clearwater, FL
  • NPI 1164459095
  Medicare reassignment Care Compare group NPD
• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200

  Emergency Medicine

  Medicare reassignment NPD
• Pasco County Emergency Physicians LLC

  • Emergency Medicine Physician
  • New Port Richey, FL
  • NPI 1568771707
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Morton Plant Hospital Association Inc

  dba Morton Plant Hospital

  • General Acute Care Hospital
  • Clearwater, FL
  • NPI 1376529743
  Care Compare affiliation

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1467034314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494",
            "telephone_number": "919-736-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144221",
            "country_code": "US",
            "telephone_number": "984-974-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACEY",
        "first_name": "BLAKE",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "STAC-DRD3UN",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2023-01786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venayagaratnam Srikantha, P.A.
• Ramaswamy Vellore Sriraman, M.D.
• SSC Goldsboro Operating Company LLC (Brian Center Health & Rehabilitation - Goldsboro)
• Samantha Michelle St John, FNP-C
• St. Vincent Home Care Services Inc.
• William James Stackhouse, M.D.
• Scott Douglas Stahle, M.D.
• Christine Eddins Stallings, FNP
• Stephanie Demetrius Stallings, LCSWA
• Victoria Stancil, PTA

• Emergency Medicine Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2025; 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.