Stacy Louise Fagan, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1779 Issued in OK

Practice address

2512 N Meridian Ave
Oklahoma City, OK 73107-1035

Phone

(405) 605-5415

Fax

(405) 605-5310

NPI assigned

Nov 13, 2008

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 OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Hospital Logan County, IncGroup PAC ID 4587836200, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Medicare reassignment Care Compare group
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Mustang Family Physicians PC

  • Family Medicine Physician
  • Mustang, OK
  • NPI 1881891653
  Medicare reassignment
• Windsor Park Medical Clinic, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1699823617
  Medicare reassignment
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Guthrie, OK
  • NPI 1184905507
  NPD
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD

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

• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Care Compare affiliation

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1841444098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 N MERIDIAN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071035",
            "telephone_number": "405-605-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 N MERIDIAN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071035",
            "telephone_number": "405-605-5415",
            "fax_number": "405-605-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "STACY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khaldun Jermaine Factory
• Modebola Fadare
• Chase Faddis
• Reanna Gabrielle Fadel
• Femi Benjamin Fafunmi, MS, LPC
• Tim R Fagan, DDS, MS
• Lillian Kay Fagg
• Jinnat Fahmida, MS,RDN/LD
• Salar Maysam Faiazi, M.D.
• Don Turon Fails

• Medical Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.