Stacy Burgess

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

License

564629 Issued in NC

Practice address

107 H St
Poplar, MT 59255-7817

Phone

(406) 768-2180

NPI assigned

Oct 18, 2022

Last updated

Oct 18, 2022By 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

Electronic endpoints 1

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1881310191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592550067",
            "telephone_number": "406-768-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 H ST",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592557817",
            "telephone_number": "406-768-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NC",
            "license": "564629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "stacyburgess@ihs.gov",
            "affiliation": "N",
            "address_1": "504 Roosevelt Ave",
            "city": "Poplar",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamala Arlene Big Eagle, BBH-LAC-LIC 86850
• Donna Black Dog
• Regina K Blevins, PHARM-D, RPH
• George Blount III
• Cassidy Jezlyn Bummer, DDS
• Louisa Cenatiempo, PHD
• Angela Rose Cheek, M.ED., M.S, PCLC
• Gloria Chopper
• Mary Le Ara Clark, PT
• William Robert Clarke, M.D.

• Body Imaging Physician in Poplar, MT
• Providers in Poplar, MT by specialty
• Body Imaging Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.