Pamela S. Stallo, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

16984 Issued in WV

Practice address

63 Corporate Center Dr
Scott Depot, WV 25560-7841

Phone

(304) 691-8870

Fax

(304) 691-1665

NPI assigned

Aug 10, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: pamela.stallo@marshall.cernerdirect.com

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.

• Stallamb P.L.L.C.

  • Pediatric Adolescent Medicine Physician
  • Scott Depot, WV
  • NPI 1245329176
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1477554574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 CORPORATE CENTER DR",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255607841",
            "telephone_number": "304-691-8870",
            "fax_number": "304-691-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 CORPORATE CENTER DR",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255607841",
            "telephone_number": "304-691-8870",
            "fax_number": "304-691-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLO",
        "first_name": "PAMELA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WV",
            "license": "16984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107899000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Pamela.Stallo@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "63 Corporate Center Dr",
            "city": "Scott Depot",
            "state": "WV",
            "country_code": "US",
            "postal_code": "255607841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Smith, OTD, OTR/L
• Paula R Smith, RPH
• Rachel Sowards, M.D.
• Misty Spaulding
• Stallamb P.L.L.C.
• Charles Douglas Stewart, PA C
• Sara Stinnett
• Krysta Stout
• Natalie Tarr
• Kelly Danielle Taylor

• Pediatric Adolescent Medicine Physician in Scott Depot, WV
• Providers in Scott Depot, WV by specialty
• Pediatric Adolescent Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.