NPIMap

Individual provider Active NPI

Richard Brandon Stacey, M.D.

  • Cardiovascular Disease Physician
  • Winston Salem, NC
National Provider Identifier
1679655526
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2008-00709 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2008-00709 NC Primary
Cardiovascular Disease Physician 207RC0000X ME117246 FL

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000726 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436299484 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of South Alabama College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Wilkes Regional Medical Center Hospital, North Wilkesboro, NC, CCN 340064
  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME117246FLMDCardiovascular Disease Physician
2008-00709NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, P.C. CurrentSince May 3, 2010 Accepting new patients
Moses Cone Physician Services, Inc. Current Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Jun 19, 2010 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Jun 19, 2010 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 20, 2010 Accepting new patients
Moses Cone Medical Services, Inc. Cardiovascular Disease CurrentSince Nov 13, 2009 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 20, 2010 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2011 Accepting new patients
Carolinas Physicians Network Inc Cardiovascular Disease Current Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Nov 13, 2009 Accepting new patients
24 On Physicians, P.C. CurrentSince May 3, 2010 Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

14 Medical Park Dr
Lexington, NC 27292
Phone (336) 238-4077

10 Medical Park Dr
Ste 2
Lexington, NC 27292
Phone (336) 716-4101

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

3990 US Highway 64 E
Murphy, NC 28906
Phone (828) 837-5939

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1679655526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "RICHARD",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2008-00709",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME117246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.