Stacey L Merritt

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

655 N Indiana Ave
Englewood, FL 34223-2756

Phone

(941) 999-4917

Fax

(941) 999-4908

NPI assigned

Jun 12, 2020

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1740805084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342232756",
            "telephone_number": "941-999-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342232756",
            "telephone_number": "941-999-4917",
            "fax_number": "941-999-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "STACEY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MCR Health, Inc. (South County Medical Center)
• Mary Elizabeth McVey, OD
• Medfacs, Corp
• Monic Menard, ARNP
• Mental Health Ctr. of Englewood, Inc
• Michele Anne Meservey
• Michael T. McCormick & Associates PA
• Michelle Pennie MD LLC
• David Sean Middleton, PA-C
• Theresa Maria Miers-Pandolfi, M.S.-SLP-CCC

• Behavior Technician in Englewood, FL
• Providers in Englewood, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.