Stacy Marie Gantz

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3 Post Office Rd Ste 105
Waldorf, MD 20602-2756

Phone

(301) 893-2345

NPI assigned

Mar 26, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1487231395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2944 GRACEFIELD RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041667",
            "telephone_number": "240-778-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 POST OFFICE RD STE 105",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022756",
            "telephone_number": "301-893-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTZ",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 Post Office Rd Ste 105",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206022756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Milton Abraham Galvan Lam, CRNP
• Estefany Garcia de la Rivera
• Christine T Gardella, PA-C
• Sandeep Kumar Garg, DMD
• Sharon Lorraine Garland, RDN
• Lynette Gassop

• Student in an Organized Health Care Education/Training Program in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Student in an Organized Health Care Education/Training Program in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.