Stacy R Bromley, PA-C
Individual provider Active NPI Physician Assistant · Milan, TN
NPI 1740340884 · NPPES record last updated Dec 2, 2015
Key facts
- NPI
- 1740340884
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2774 (TN)
- Practice address
- 4039 Highland St
Milan, TN 38358-3483 - Phone
- (731) 686-8995
- Fax
- (731) 686-8997
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Kentucky College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crossroads Urgent Care PLLC
Consolidated Medical Practices of Memphis,PLLC
Practice addresses (Care Compare)
2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900
397 New Byhalia Rd
Collierville, TN 38017-3705
Phone (901) 860-0536
6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700
Hospital & facility affiliations
- Baptist Memorial Hospital
- Methodist Hospitals of Memphis
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151216000241 | TN | Practitioner - Physician Assistant | 6608924600 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2774 | TN | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Urgent Care PLLC | Physician Assistant | Current |
Accepting new patients |
| Crossroads Urgent Care PLLC | Physician Assistant | Current |
Accepting new patients |
| The Ophthalmology Group, LLC | Past |
Accepting new patients |
Locations
397 New Byhalia Rd
#R
Collierville, TN 38017
2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900
30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2774 | TN | Yes |
Addresses
Primary practice location
4039 Highland St
Milan, TN 38358-3483
Mailing address
PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752
Other providers in Milan, TN
- Carol D Belong
- Beyond Words Therapy Clinic, PLLC
- Carol D Blair
- Kimberly Blankenship
- William Timothy Brewer
- Madalyn R Bryan
- David Edward Buford
- Taylor Caldwell
- Anna Callins
- Brooke Canovan
All providers in Milan, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.