Active NPI
Tina Boyd Stacy, PHARMD
- Oncology Pharmacist
- Canton, GA
National Provider Identifier
1730074337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Pharmacist
- License
- 0202011358
- Practice address
- 4465 Hickory Flat Hwy
Canton, GA 30115-9317 - Phone
- (404) 425-4474
- NPI assigned
- Jun 12, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | RPH019560 | GA | |
| Oncology Pharmacist | 1835X0200X | 0202011358 | VA | Primary |
Addresses
Primary practice location
4465 Hickory Flat Hwy
Canton, GA 30115-9317
Mailing address
4465 Hickory Flat Hwy
Canton, GA 30115-9317
Phone (404) 425-4474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH019560 | GA | MD | Oncology Pharmacist |
| 0202011358 | VA | MD | Oncology Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1730074337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4465 HICKORY FLAT HWY",
"city": "CANTON",
"state": "GA",
"postal_code": "301159317",
"telephone_number": "404-425-4474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4465 HICKORY FLAT HWY",
"city": "CANTON",
"state": "GA",
"postal_code": "301159317",
"telephone_number": "404-425-4474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACY",
"first_name": "TINA",
"middle_name": "BOYD",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-12",
"last_updated": "2025-06-12",
"certification_date": "2025-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "GA",
"license": "RPH019560",
"primary": false
},
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "VA",
"license": "0202011358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.