Stacy Ann Vencill, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA18107 Issued in CA

Practice address

4870 Barranca Pkwy
350
Irvine, CA 92604-4709

Phone

(949) 451-6060

Fax

(949) 451-6070

NPI assigned

Feb 13, 2007

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

• Ms. Stacy Ann Heckman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1629110655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15243",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926595243",
            "telephone_number": "949-574-4600",
            "fax_number": "949-574-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 BARRANCA PKWY",
            "address_2": "350",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044709",
            "telephone_number": "949-451-6060",
            "fax_number": "949-451-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENCILL",
        "first_name": "STACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HECKMAN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pauline Velasquez, LVN
• Jared Velazquez
• Lilianna Grace Veldhuis
• Nathan Velez
• David Frederick Velkoff, M.D.
• Colin Venida
• Harshitha V Venkatesh
• Udhayabanu Venkatrajan
• Kristin Caitlin Venning, LMFT
• Ventura Hospice and Palliative Care

• Medical Physician Assistant in Irvine, CA
• Providers in Irvine, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.