Stacey Raybuck

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

008112 Issued in AZ

Practice address

101 Westpark Dr
Brentwood, TN 37027-5031

Phone

(910) 310-4551

NPI assigned

Jun 12, 2006

Last updated

May 19, 2023By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Nexus Wound Consultants LLC

  • Family Medicine Physician
  • Salem, OR
  • NPI 1831927052
  Medicare reassignment NPD
• Online Wound Care Group PLLC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1487345369
  NPD Authorized official
• Nexus Wound Consultants LLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1104698588
  NPD
• Arizona Health Services PLLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1386267524
  NPD (past)
• Davis Hospital Holdings, Inc.

  • Contractor
  • Layton, UT
  • NPI 1851333249
  NPD (past)
• Excelled Healing LLC

  • Family Nurse Practitioner
  • Snohomish, WA
  • NPI 1013742964
  NPD (past)
• Geneva County Healthcare Authority, Inc.

  dba Samson Medical Clinic

  • Family Medicine Physician
  • Samson, AL
  • NPI 1457448946
  NPD (past)
• Kenneth L Pettit DO LLC

  dba Comprehensive Family Care

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1750585279
  NPD (past)
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1720020076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 N PIEDRA CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852070809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WESTPARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275031",
            "telephone_number": "910-310-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBUCK",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "008112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767741",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102413281",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance Elaine Rawls, FNPC
• Erin Hope Ray
• Kaka Lyn Ray, LMFT
• Kelsi Ray, MMFT
• Raven Rayborn
• Elayne Haley Rayburn, OTR/L
• Rachel Rayl
• RB Medical
• RCHP Montana LLC
• RCHP Montana LLC

• Family Medicine Physician in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.