Darin O'Shea Stites II, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6095 Issued in TN

Practice address

1760 Tank Two Rd
Ridgely, TN 38080-6201

Phone

(720) 512-1046

NPI assigned

Jun 11, 2024

Last updated

Aug 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1871335679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 TANK TWO RD",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "380806201",
            "telephone_number": "720-512-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 TANK TWO RD",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "380806201",
            "telephone_number": "720-512-1046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 US Highway 51 Byp W",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380241950",
            "country_code": "US",
            "telephone_number": "731-325-3473",
            "fax_number": "731-325-3474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STITES",
        "first_name": "DARIN",
        "middle_name": "O'SHEA",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6095",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citizens of Lake County for Health Care Inc (William B, Acree Clinic)
• Anna Davis, APRN
• HQM of Ridgely, LLC (Ridgely Care & Rehabilitation Center)
• Nettie Sue Hurst, NURSE PRACTITIONER
• LP Ridgely LLC (Signature HealthCARE of Ridgely Rehab & Wellness Center)
• Taylor Bros Pharmacy LLC

• Physician Assistant in Ridgely, TN
• Providers in Ridgely, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.