Active NPI
Stacey Vanvliet, M.D.
- Hospitalist Physician
- Fort Worth, TX
National Provider Identifier
1881950194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- Q3610
- Practice address
- 801 7TH Ave
Fort Worth, TX 76104-2733 - Phone
- (682) 885-1475
- Fax
- (682) 885-7520
- NPI assigned
- Apr 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | Q3610 | TX | Primary |
Addresses
Primary practice location
801 7TH Ave
Fort Worth, TX 76104-2733
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855
Other names 1
- Stacey Haberberger
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | svanvliet17606@CookChildrens.direct-ci.com |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Q3610 | TX | MD | Hospitalist Physician |
Interoperability endpoints
- svanvliet17606@cookchildrens.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1881950194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 733784",
"city": "DALLAS",
"state": "TX",
"postal_code": "753733784",
"telephone_number": "682-885-1855",
"fax_number": "682-885-1396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 7TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042733",
"telephone_number": "682-885-1475",
"fax_number": "682-885-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANVLIET",
"first_name": "STACEY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-11",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "TX",
"license": "Q3610",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "svanvliet17606@CookChildrens.direct-ci.com",
"affiliation": "N",
"address_1": "801 7th Ave",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761042733",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "STACEY",
"last_name": "HABERBERGER",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.