Stacie Wharton, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003268 Issued in IL

Practice address

431 West Liberty Street
Wauconda, IL 60084

Phone

(847) 526-2151

Fax

(815) 678-4184

NPI assigned

Oct 10, 2008

Last updated

Dec 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JFGJCA

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.

• From Pain to Wellness, LLC

  • Pain Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1477738227
  Medicare reassignment NPD

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1639321482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 REMINGTON BLVD",
            "address_2": "UNIT 205",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405827",
            "telephone_number": "630-226-1130",
            "fax_number": "360-226-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 WEST LIBERTY STREET",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "60084",
            "telephone_number": "847-526-2151",
            "fax_number": "815-678-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHARTON",
        "first_name": "STACIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "085003268",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wauconda Physical Therapy, Inc.
• Ahmad Wehbi
• Kelly Elizabeth Weller
• West Suburban Vision Care Inc.
• Rebecca Joy Westrate, FNP-C
• Mary M Williams, COTA/L
• Derek Wolken, FNP
• William Richard Womer, DC
• Megan Leigh Wurzbach

• Physician Assistant in Wauconda, IL
• Providers in Wauconda, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.