NPIMap

Individual provider Active NPI

Philip Edward Stack, M.D.

  • Gastroenterology Physician
  • Sylva, NC
National Provider Identifier
1770678591
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
9400644 Issued in NC
Practice address
26 Westcare Drive
Suite 302
Sylva, NC 28779-5278
Phone
(828) 586-9200
Fax
(828) 586-7459
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 9400644 NC Primary

Addresses

Primary practice location

26 Westcare Drive
Suite 302
Sylva, NC 28779-5278

Mailing address

26 Westcare Drive
Suite 302
Sylva, NC 28779-5278
Phone (828) 586-9200

Other identifiers 2

IdentifierTypeStateIssuer
79118OtherNCBLUE CROSS BLUE SHEILD
8979118MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000560 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 3971695537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Oral Roberts University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Carolina Digestive Consultants PAGroup PAC ID 8820065477, 8 clinicians

Practice addresses (Care Compare)

26 Westcare Dr
Suite 302
Sylva, NC 28779-5278
Phone (828) 586-9200

Hospital & facility affiliations

  • Harris Regional Hospital Hospital, Sylva, NC, CCN 340016
  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy175
Upper gastrointestinal (GI) endoscopy for acid reflux264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Western Carolina Endoscopy Center, LLC Current Accepting new patients
DLP Western Carolina Physician Practices LLC Gastroenterology CurrentSince Oct 4, 2017 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Oct 4, 2017 Accepting new patients
Western Carolina Digestive Consultants PA Gastroenterology CurrentSince Jan 1, 1995 Accepting new patients
Western Carolina Digestive Consultants Current Accepting new patients

Locations

26 Westcare Dr
Ste 304
Sylva, NC 28779
Phone (704) 586-7456

98 Doctors Dr
Ste 310
Sylva, NC 28779
Phone (828) 586-3976

26 Westcare Dr
Ste 302
Sylva, NC 28779
Phone (828) 586-7427

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

Interoperability endpoints

  • FHIR API: https://35e809af-55fd-4464-b97b-98cb80ebf600.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1770678591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WESTCARE DRIVE",
            "address_2": "SUITE 302",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795278",
            "telephone_number": "828-586-9200",
            "fax_number": "828-586-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 WESTCARE DRIVE",
            "address_2": "SUITE 302",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795278",
            "telephone_number": "828-586-9200",
            "fax_number": "828-586-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "PHILIP",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9400644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "79118",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8979118",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

Verify at the official NPI Registry.