Stacey Tillman Suttles, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

BLD 681, 1St Floor
Schofield Barracks, HI 96857

Phone

(808) 433-8475

NPI assigned

Jun 22, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1578826681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USARMY HEALTH CLINICS SCHOFIELD BARRACKS",
            "address_2": "BLD 683, ATTN: FNS BLD 681, RM 126",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96857",
            "telephone_number": "808-433-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLD 681, 1ST FLOOR",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96857",
            "telephone_number": "808-433-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTLES",
        "first_name": "STACEY",
        "middle_name": "TILLMAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Schofield Vision Center, Inc.
• Shawn J Scott, P.T.
• Jessica E. Simmonds, PH.D.
• Priscilla Fuentes Smith, LCSW
• Ryan Connor Smith, DDS
• Sandra Jamilla Tajon, RDH
• Mildred Tang
• Ryan Tatsumoto, PHARM.D.
• The Janz Corporation (Janz Medical Supply)
• Tripler Army Medical Center (Usadc Hawaii Schofield BKS)

• Physician Assistant in Schofield Barracks, HI
• Providers in Schofield Barracks, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.