Stacy Edwards, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS7714 Issued in FL

Legal business name

STACY EDWARDS, INC

Doing business as

Stacy L. Edwards, D.O.

Practice address

2623 McCormick Dr Ste 101
Clearwater, FL 33759-1046

Phone

(727) 564-9336

Fax

(727) 223-3228

NPI assigned

Jul 15, 2006

Last updated

Oct 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stacy L Edwards, DONPI 1700812690

Title

Physician

Phone

(727) 410-6655

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• STACY L. EDWARDS, D.O. Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy L Edwards, DO

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1700812690
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1730105172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 MAIN ST",
            "address_2": "SUITE M",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346985225",
            "telephone_number": "727-733-7922",
            "fax_number": "737-738-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 MCCORMICK DR STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591046",
            "telephone_number": "727-564-9336",
            "fax_number": "727-223-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY EDWARDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-410-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS7714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0412595",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "123421",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20886",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "257297",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0001713",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BAYCARE",
            "identifier": "1320",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0161979008",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1057441",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5580758",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STACY L. EDWARDS, D.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Patricia St. John, M.D.
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• Internal Medicine Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.