Taylor Jo Stack, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

170 Manning Drive
CB 7070
Chapel Hill, NC 27599-7025

Phone

(984) 984-6484

Fax

(991) 996-6794

NPI assigned

Apr 22, 2024

Sex

Female

Sole proprietor

No

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: tstack552774@directhisp.wakemed.org

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1780439810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MANNING DRIVE",
            "address_2": "CB 7070",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997025",
            "telephone_number": "919-966-3343",
            "fax_number": "991-996-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MANNING DRIVE",
            "address_2": "CB 7070",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997025",
            "telephone_number": "984-984-6484",
            "fax_number": "991-996-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "TAYLOR",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riti Srivastava
• Carly Sronce, DNP
• Haley Morgan St John, MD
• Alessandra Stachowski, MSW
• Richard Sean Stack, M.D.
• Ashlyn Stackhouse, CGC
• Clare Andrea Stadlen, LCSW
• Mark Stafford, BCBA,LPA
• Renae E Stafford, MD
• Sarah Grace Stafford, MD

• Student in an Organized Health Care Education/Training Program in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.