Individual provider Active NPI

Stacy R Flickner-Garvey, R.D.

  • Registered Dietitian
  • Feeding Hills, MA
National Provider Identifier
1528298205
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
914 Issued in MA
Practice address
14 S Westfield St
Feeding Hills, MA 01030-2702
Phone
(413) 786-2957
Fax
(413) 786-2977
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 914 MA Primary

Addresses

Primary practice location

14 S Westfield St
Feeding Hills, MA 01030-2702

Mailing address

14 S Westfield St
Feeding Hills, MA 01030-2702
Phone (413) 786-2957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150918002225 MA Practitioner - Registered Dietitian Or Nutrition Professional 0345557641 Reassigns benefits to 1 organization
I20200130001833 CT Practitioner - Registered Dietitian Or Nutrition Professional 0345557641

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellpoint Health Solutions LLCGroup PAC ID 0143582262, 6 clinicians

Practice addresses (Care Compare)

95 Post Office Park
Suite 9523
Wilbraham, MA 01095-1199
Phone (413) 258-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
914MAMDAthletic Trainer

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1528298205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S WESTFIELD ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010302702",
            "telephone_number": "413-786-2957",
            "fax_number": "413-786-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S WESTFIELD ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010302702",
            "telephone_number": "413-786-2957",
            "fax_number": "413-786-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICKNER-GARVEY",
        "first_name": "STACY",
        "middle_name": "R",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Feeding Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.