Individual provider Active NPI

Stacey Menard

  • Other Specialist/Technologist
  • Hallandale Beach, FL
National Provider Identifier
1508300625
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Practice address
415 NE 2ND St Apt 120
Hallandale Beach, FL 33009-4363
Phone
(305) 834-3698
NPI assigned
Dec 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X Primary

Addresses

Primary practice location

415 NE 2ND St Apt 120
Hallandale Beach, FL 33009-4363

Mailing address

415 NE 2ND St Apt 120
Hallandale Beach, FL 33009-4363

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1508300625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 NE 2ND ST APT 120",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 NE 2ND ST APT 120",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094363",
            "telephone_number": "305-834-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENARD",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.