Jerry Michael Stanton, D.O.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

G1555 Issued in TX

Practice address

1600 Central Dr
Suite 160
Bedford, TX 76022-6000

Phone

(817) 268-0104

Fax

(817) 268-6102

NPI assigned

Jul 20, 2006

Last updated

Mar 7, 2013By the provider in NPPES

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

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60095

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.

• Metroplex Pain Management, P.a.

  • Certified Registered Nurse Anesthetist
  • Bedford, TX
  • NPI 1396800223
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1679593891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL DR",
            "address_2": "SUITE 160",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226000",
            "telephone_number": "817-268-0104",
            "fax_number": "817-268-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL DR",
            "address_2": "SUITE 160",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226000",
            "telephone_number": "817-268-0104",
            "fax_number": "817-268-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "JERRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "G1555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EEOICP",
            "identifier": "006895499",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050033686",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "528901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116585401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "86W010",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR LONDON KY",
            "identifier": "180403400",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2028260",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS WORK COMP",
            "identifier": "DOG1555",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10028066",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4389652",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Lee Stafford, ATC, LAT
• Maury Edward Staggs, RPH
• Lisa Stajduhar
• Marty Stajduhar, PHYSICAL THERAPY
• Armon Javon Stanford, DC
• Patrick Kevin Stanton, D.O.
• Michael Chad Stapleton, D.D.S.
• Starlight DME LLC
• Sterling Steed
• Ralph Steele, BCPC

• Interventional Pain Medicine Physician in Bedford, TX
• Providers in Bedford, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.