Individual provider Active NPI

Matthew Ward Stacey, D.D.S.

  • General Practice Dentistry
  • Asheville, NC
National Provider Identifier
1740203124
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7182 Issued in NC
Practice address
417 Biltmore Ave
2-C Doctors Park
Asheville, NC 28801-4543
Phone
(828) 252-3591
Fax
(828) 252-7591
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7182 NC Primary

Addresses

Primary practice location

417 Biltmore Ave
2-C Doctors Park
Asheville, NC 28801-4543

Mailing address

1200 Centre Park Dr
Ste 100
Asheville, NC 28805-6108
Phone (828) 252-3591

Other identifiers 1

IdentifierTypeStateIssuer
89902EKMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160405000341 NC Order and Referring Only - DentistPractitioner - Dentist 9133426273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Flaherty & Stacey. PA General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1740203124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CENTRE PARK DR",
            "address_2": "STE 100",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288056108",
            "telephone_number": "828-252-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 BILTMORE AVE",
            "address_2": "2-C DOCTORS PARK",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014543",
            "telephone_number": "828-252-3591",
            "fax_number": "828-252-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "MATTHEW",
        "middle_name": "WARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902EK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.