Stacy Maria Washington, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

13105 Issued in CA

Practice address

2120 E Calvada Blvd
Pahrump, NV 89048-5805

Phone

(775) 727-8300

NPI assigned

Jul 19, 2006

Last updated

Aug 1, 2013By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

• DHHS PHS Naihs Fort Defiance Hospital

  dba PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1679592349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 SHADOW BEND DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351252",
            "telephone_number": "714-600-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485805",
            "telephone_number": "775-727-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "STACY",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13105",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17773580",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Ann Walter, PSYD
• Amelia Suzanne Walton
• Jim Wang, DO
• Demi Allison Warrick
• Rachel Washington
• Tiffany Lawanna Washington
• Joshua Alan Weiberg, PSYD
• Graham Weiss
• Lauren Alicia Elaine Welch, BA
• Westcare Nevada

• Optometrist in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.