Staci Leigh Clutter, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

801 Medical Dr Ste a
Lima, OH 45804-4030

Phone

(419) 222-6622

Fax

(419) 224-0015

NPI assigned

Aug 28, 2018

Last updated

Feb 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Staci Leigh Braun Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercer County Joint Township Community HospitalGroup PAC ID 8820081755, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercer County Joint Township Community Hospital

  dba Mercer Health

  • General Acute Care Hospital
  • Coldwater, OH
  • NPI 1497784144
  Medicare reassignment Care Compare group NPD
• Diagnostic Pathology, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Coldwater, OH
  • NPI 1366639197
  NPD
• Mercer County Joint Township Community Hospital

  dba mercer health medical equipment

  • Durable Medical Equipment & Medical Supplies
  • Coldwater, OH
  • NPI 1609963198
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)

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

• Mercer County Joint Township Community Hospital

  dba Mercer Health

  • General Acute Care Hospital
  • Coldwater, OH
  • NPI 1497784144
  Care Compare affiliation

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1679054464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 FLECK AVE",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458228738",
            "telephone_number": "419-953-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUTTER",
        "first_name": "STACI",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "BRAUN",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Physician Assistant in Lima, OH
• Providers in Lima, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.