Soni Elizabeth Stake, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

40468 Issued in AZ

Practice address

100 E 5TH St
Douglas, AZ 85607-2859

Phone

(520) 364-7659

Fax

(520) 364-8541

NPI assigned

Jul 26, 2007

Last updated

Sep 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bisbee Hospital Association

  • Critical Access Hospital
  • Bisbee, AZ
  • NPI 1518968767
  Medicare reassignment NPD
• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Kayenta, AZ
  • NPI 1174692529

  TX

  Medicare reassignment NPD
• Bisbee Hospital Association

  dba Copper Queen Community Hospital Hereford RHC

  • Rural Health Clinic/Center
  • Hereford, AZ
  • NPI 1245986975
  NPD
• Kayenta Alternative Rural Hospital

  dba Inscription House Health Center

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD
• Kayenta Alternative Rural Hospital

  dba Dennehotso Health Center

  • General Acute Care Hospital
  • Dennehotso, AZ
  • NPI 1821167297
  NPD
• United Community Health Center - Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vail, AZ
  • NPI 1528311958
  NPD (past)
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Amado, AZ
  • NPI 1063732675
  NPD (past)
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1760663389
  NPD (past)
• Valley Surgical Clinics, LTD

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1962440602
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1487844395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E EDNA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322101",
            "telephone_number": "313-570-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 5TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072859",
            "telephone_number": "520-364-7659",
            "fax_number": "520-364-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKE",
        "first_name": "SONI",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "40468",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "40468",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "40468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362117",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Eastern Arizona Behavioral Health Services, Inc. (Douglas Integrated Counseling Clinic)
• Southeastern Arizona Behavioral Health Service, Inc
• Southeastern Arizona Behavioral Health Services, Inc.
• Betty Lynn Spering, LISAC, MS
• Sean Marshall Spurr, D.O.
• Maria R Suarez
• Guadalupe G Tapia, LCSW
• Alaine A Taylor, FNP
• Devyn R Thurber, PNP
• Walter Tucker, MS, LPC, NCC, BHP

• General Practice Physician in Douglas, AZ
• Providers in Douglas, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.