Individual provider Active NPI

Stephanie Elnora Stafford, DO MPH

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1720031321
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M9027 Issued in TX
Practice address
1122 Jackson St Unit 407
Dallas, TX 75202
Phone
(805) 471-3666
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X M9027 TX
Emergency Medicine Physician 207P00000X 1209 NV
Family Medicine Physician 207Q00000X 1209 NV
Public Health & General Preventive Medicine Physician 2083P0901X M9027 TX
Hospitalist Physician 208M00000X M9027 TX
Family Medicine Physician 207Q00000X M9027 TX Primary

Addresses

Primary practice location

1122 Jackson St Unit 407
Dallas, TX 75202

Mailing address

1122 Jackson St Unit #407
Unit 407
Dallas, TX 75202
Phone (805) 471-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20041117000574 TX Practitioner - Family PracticePractitioner - Emergency Medicine 6507820792 Reassigns benefits to 6 organizations
Practice locations: Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yan Li, MD., PHD., P.a.Group PAC ID 8224920228, 2 clinicians

Practice addresses (Care Compare)

3413 Spectrum Blvd
Suite 100
Richardson, TX 75082-9705
Phone (972) 884-4160

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1209NVMDEmergency Medicine Physician
1483TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Family Medicine CurrentSince Dec 18, 2016 Accepting new patients
Yan Li, MD., PHD., P.a. Family Medicine CurrentSince Sep 21, 2024 Accepting new patients
Texas Health Physicians Group CurrentSince Dec 18, 2016 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Oct 20, 2015 Accepting new patients
Hni Medical Services Family Medicine CurrentSince Apr 17, 2015 Accepting new patients
Lonestar Hospital Medicine Associates, PA Emergency Medicine CurrentSince Apr 1, 2014 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Oct 20, 2015 Accepting new patients
Valora Medical Center LLC CurrentSince Jun 1, 2021 Accepting new patients
CD Urgent Care Center 5, PLLC PastSince Mar 4, 2014 Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
Paul Phillips III, M.D., P.a. PastSince Nov 1, 2012 Accepting new patients
Quantum Healthcare Medical Associates Inc. Family Medicine Past Accepting new patients
Nopah Vista Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Rosebud Indian Health Service Past Accepting new patients
Premier Provider Health PA Past Accepting new patients
United Emergency Services of Tennessee, LLC Emergency Medicine Past Accepting new patients
Nghi B Phan MD, PA Hospitalist Past Accepting new patients

Locations

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

6130 Parkway Dr
Corpus Christi, TX 78414
Phone (361) 826-5785

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

1004 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (214) 677-1300

512 Victoria Ln
Ste 12
Harlingen, TX 78550
Phone (956) 440-6322

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

5601 Executive Dr
Ste 200
Irving, TX 75038
Phone (352) 565-7290

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

4666 McDermott Rd
Ste 100
Plano, TX 75024
Phone (972) 668-6868

4040 McDermott Rd
Ste 100
Plano, TX 75024
Phone (972) 658-6868

3413 Spectrum Blvd
#100
Richardson, TX 75082
Phone (972) 668-6868

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

1050 E State Highway 114
Ste 100
Southlake, TX 76092
Phone (817) 329-8364

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

605 Holderrieth Blvd
Tomball, TX 77375
Phone (281) 401-7500

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1720031321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 JACKSON ST UNIT #407",
            "address_2": "UNIT 407",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75202",
            "telephone_number": "805-471-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 JACKSON ST UNIT 407",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75202",
            "telephone_number": "805-471-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "STEPHANIE",
        "middle_name": "ELNORA",
        "name_prefix": "Dr.",
        "credential": "DO MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "M9027",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "1209",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "1209",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "M9027",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M9027",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.