Active NPI
April Marie Stoddard, P.A.C.
- Physician Assistant
- MC Kenzie, TN
National Provider Identifier
1568623957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1613
- Practice address
- 205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649 - Phone
- (731) 352-7907
- Fax
- (731) 352-4459
- NPI assigned
- Jun 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1613 | TN | Primary |
Addresses
Primary practice location
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Mailing address
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3380640 | Other | TN | MEDICAID GROUP |
| 3380640 | Other | TN | MEDICARE GROUP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1613 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie Medical Center PC | Physician Assistant | Current | Accepting new patients |
| Hub City Emergency Physicians LLC | Past | Accepting new patients | |
| McKenzie Medical Center, PC | Physician Assistant | Past | Accepting new patients |
| McKenzie Medical Center PC | Physician Assistant | Past | Accepting new patients |
Locations
205 Hospital Dr
Ste A
Mc Kenzie, TN 38201
Phone 7313527907 ext. 429
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- MC Kenzie, TN
- NPI 1477516953
Physician Assistant
-
- Emergency Medicine Physician
- Jackson, TN
- NPI 1972552651
-
- Rural Health Clinic/Center
- Bruceton, TN
- NPI 1245401231
Physician Assistant
-
- Rural Health Clinic/Center
- Gleason, TN
- NPI 1225083991
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1568623957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 HOSPITAL DR",
"address_2": "SUITE A",
"city": "MC KENZIE",
"state": "TN",
"postal_code": "382011649",
"telephone_number": "731-352-7907",
"fax_number": "731-352-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 HOSPITAL DR",
"address_2": "SUITE A",
"city": "MC KENZIE",
"state": "TN",
"postal_code": "382011649",
"telephone_number": "731-352-7907",
"fax_number": "731-352-4459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "APRIL",
"middle_name": "MARIE",
"credential": "P.A.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "1613",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "3380640",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "3380640",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in MC Kenzie, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.