Trisha Nicole Stacks, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

34.013376 Issued in OH

Practice address

11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106-1716

Phone

(216) 844-3887

NPI assigned

Apr 15, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1679969703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 FAIRMOUNT BLVD STE 315",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063164",
            "telephone_number": "216-302-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "address_2": "UNIVERSITY HOSPITALS CASE MEDICAL CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKS",
        "first_name": "TRISHA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.013376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Vincent Charity Medical Center
• St. Vincent Charity Medical Center
• St. Vincent Charity Medical Center
• Alyssa Charlotte Stachowiak
• Kathryn Stackhouse
• Connie G Stading, QMHS, CMS
• Maksim Stadnik, CRNA
• Anthony Stafford, MD, FRCSI
• Corey James Stafford, DMD
• Ethel Stafford

• Psychiatry Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.