Corey Andrew Ernst Stack, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

99102 Issued in GA

Practice address

1924 Alcoa Hwy # U-109
Knoxville, TN 37920-1511

Phone

(865) 305-9220

Fax

(865) 305-9216

NPI assigned

Mar 26, 2020

Sex

Male

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Medical College of Georgia School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Candler Hospital Hospital, Savannah, GA, CCN 110024
• Optim Medical Center - Tattnall Hospital, Reidsville, GA, CCN 111323
• Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  Medicare reassignment Care Compare group NPD

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

• Beaufort County Memorial Hospital

  • General Acute Care Hospital
  • Beaufort, SC
  • NPI 1366436073
  Care Compare affiliation
• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation
• Tattnall Hospital Company, LLC

  • Critical Access Hospital
  • Reidsville, GA
  • NPI 1790942381
  Care Compare affiliation

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1659908820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-109",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9220",
            "fax_number": "865-305-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-109",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9220",
            "fax_number": "865-305-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "COREY",
        "middle_name": "ANDREW ERNST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "99102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Mary'S Ambulatory Surgery Center LLC
• St. Mary'S Holston Health and Rehabilitation Center, Inc.
• Emalee St. Pierre, PA-C
• Jeffrey Blair Staack, M.D.
• Allison Marie Staackmann, LMSW
• Mia J Staehling, RBT
• Tracy Staff
• Courtney Stafford, M.S., CF-SLP
• Elizabeth Stafford
• Jami L Stafford, MACCC-SLP

• Anesthesiology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.