Individual provider Active NPI

Stacy Debra Kline, LM

  • Lay Midwife
  • Lakeland, FL
National Provider Identifier
1861759466
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lay MidwifeTaxonomy code 175M00000X
License
MW256 Issued in FL
Practice address
1525 Edgewater Beach Dr
Lakeland, FL 33805-4737
Phone
(863) 680-2229
Fax
(863) 682-4784
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X MW256 FL Primary

Addresses

Primary practice location

1525 Edgewater Beach Dr
Lakeland, FL 33805-4737

Mailing address

1525 Edgewater Beach Dr
Lakeland, FL 33805-4737
Phone (863) 680-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MW256FLMDLay Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Celebrate Birth Midwifery, Inc Past Accepting new patients
Labor of Love Childbirth Services, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1861759466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 EDGEWATER BEACH DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054737",
            "telephone_number": "863-680-2229",
            "fax_number": "863-682-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 EDGEWATER BEACH DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054737",
            "telephone_number": "863-680-2229",
            "fax_number": "863-682-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "STACY",
        "middle_name": "DEBRA",
        "credential": "LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "FL",
            "license": "MW256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.