Mary Elizabeth Stockdale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4119 Issued in TN

Practice address

3443 Dickerson Pike Ste 300
Nashville, TN 37207-2523

Phone

(615) 549-7073

NPI assigned

Jul 21, 2020

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 names 1

• Lisa Stockdale Other name

Medicare fee-for-service enrollment

Enrolled in TN, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.elizabeth.stockdale.1@30646.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4

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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813

  WA

  Medicare reassignment
• Neuro Resource PC

  • Neurology Physician
  • Nashville, TN
  • NPI 1114041548
  NPD (past)
• Zoomcare PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1568070043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE",
            "address_2": "STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072523",
            "telephone_number": "205-213-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072523",
            "telephone_number": "615-549-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKDALE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "STOCKDALE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catherine Stober, MD
• Alaina Stochaj-Oman, WHNP-BC
• Harlan M. Stock, M.D.
• Jennifer Stock, LPC-MHSP
• Garrett Stockdale, PA-C
• Haley Stocker
• Katherine Eileen Stockham
• Julie Ann Stockman, CRNA
• Courtney Stocks, PA-C
• Michael D. Stockwell, M.D.

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.
• 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.