Individual provider Active NPI

Stacie Briggs, PA-C

  • Physician Assistant
  • Dewitt, MI
National Provider Identifier
1609530641
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010727 Issued in MI
Practice address
12805 Escanaba Dr
Dewitt, MI 48820-8628
Phone
(517) 913-3930
Fax
(517) 333-1769
NPI assigned
Oct 26, 2021
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010727 MI Primary

Addresses

Primary practice location

12805 Escanaba Dr
Dewitt, MI 48820-8628

Mailing address

12805 Escanaba Dr
Dewitt, MI 48820-8628
Phone (517) 913-3930

Other practice location 1

200 N Caledonia Dr
Owosso, MI 48867-8844
Phone (989) 729-4848

Other names 1

  • Stacie Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211028002806 MI Practitioner - Physician Assistant 0345638003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

12805 Escanaba Dr
Suite 1
Dewitt, MI 48820-8628
Phone (517) 913-3930

2270 Jolly Oak Rd
Suite 1
Okemos, MI 48864-6932
Phone (517) 975-9475

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group CurrentSince Jul 1, 2024 Accepting new patients
McLaren Medical Group Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Dec 6, 2021 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Dec 6, 2021 Accepting new patients
McLaren Medical Group Past Accepting new patients

Locations

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

12805 Escanaba Dr
Dewitt, MI 48820
Phone (517) 367-5500

12805 Escanaba Dr
Ste 1
Dewitt, MI 48820
Phone (517) 913-3930

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

200 N Caledonia Dr
Owosso, MI 48867
Phone (989) 720-4188

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1609530641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 ESCANABA DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208628",
            "telephone_number": "517-913-3930",
            "fax_number": "517-333-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 ESCANABA DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208628",
            "telephone_number": "517-913-3930",
            "fax_number": "517-333-1769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 N Caledonia Dr",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488678844",
            "country_code": "US",
            "telephone_number": "989-729-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIGGS",
        "first_name": "STACIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dewitt, MI

Sources for this page

Verify at the official NPI Registry.