Stacy A McConkey, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME 113754 Issued in FL

Practice address

15502 Stoneybrook West Pkwy
Suite 2-108
Winter Garden, FL 34787-4767

Phone

(407) 656-0042

Fax

(407) 656-0663

NPI assigned

Sep 19, 2005

Last updated

Jul 29, 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 2

Other names 1

• Stacy A Yoder Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smcconkey73489@adventhealth.direct-ci.com

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Pediatrics

  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1710972492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15502 STONEYBROOK WEST PKWY",
            "address_2": "SUITE 2-108",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874767",
            "telephone_number": "407-656-0042",
            "fax_number": "407-656-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15502 STONEYBROOK WEST PKWY",
            "address_2": "SUITE 2-108",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874767",
            "telephone_number": "407-656-0042",
            "fax_number": "407-656-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONKEY",
        "first_name": "STACY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "32386",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 113754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251819",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "43666",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "YODER",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Douglas McCleary, M.D.
• Jalisa McCleskey
• Katie McClish
• Abigail Christine McClung
• Benjamin Thomas McCluske, AP. , LMT.
• Dixie McCune, PHARMD
• Christopher McGee Jr.
• Donna McGurer-Bryant, LCSW
• Ta'Shae McKinnon, PHARMD
• Gemma McNeil

• Pediatrics Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.