Amber Stacy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004833 Issued in VA

Practice address

202 N Washington Ave
Pulaski, VA 24301-5022

Phone

(540) 643-0526

NPI assigned

May 6, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1801417340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CRITZER DR",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243017007",
            "telephone_number": "304-952-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N WASHINGTON AVE",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243015022",
            "telephone_number": "540-643-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Kay Smith, LPTA
• Mary Smith
• Cynthia Martin Southern, DDS
• Southwest Surgical Associates, Inc.
• Robert Springer, CRNA
• Eric Christian Steen, DO
• Sierra Stuart, LPN
• Surgical Associates of Southwest Virginia, LLC
• Mary Tekesky
• Thomas William Templeton, M.D.

• Speech-Language Pathologist in Pulaski, VA
• Providers in Pulaski, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.