Stacey Johnson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38781 Issued in KY

Practice address

464 Ky Highway 699
Cornettsville, KY 41731

Phone

(606) 476-2593

Fax

(606) 476-2347

NPI assigned

Jun 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Other names 1

• Stacey Campbell Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448

  Family Medicine

  Medicare reassignment NPD
• Community Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Glasgow, KY
  • NPI 1588766349
  NPD (past)
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851328900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "41858",
            "telephone_number": "606-633-4823",
            "fax_number": "606-633-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 KY HIGHWAY 699",
            "city": "CORNETTSVILLE",
            "state": "KY",
            "postal_code": "41731",
            "telephone_number": "606-476-2593",
            "fax_number": "606-476-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64881600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "CAMPBELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda Cornett
• Teresa Day
• Kelcie Logan Gregory, DO
• Matthew Holbrook, PA C
• Susan Hull, FNP
• L B Clinic Pharmacy
• Mountain Comprehensive Health Corporation (Leatherwood Elementary School Based Clinic)
• Mountain Comprehensive Health Corporation
• Mountain Comprehensive Health Corporation (Leatherwood Pharmacy)
• Austin Parker Roberts, PA-C

• Family Medicine Physician in Cornettsville, KY
• Providers in Cornettsville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.