Stacy Southall, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN9317006 Issued in FL

Practice address

1800 Mercy Dr
Suite 302
Orlando, FL 32808-5646

Phone

(407) 875-3700

Fax

(407) 522-4671

NPI assigned

Sep 7, 2011

Last updated

Sep 7, 2011By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Aspire Health Partners, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Orlando, FL
  • NPI 1821033903
  NPD (past)

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1902187784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MERCY DR",
            "address_2": "SUITE 302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085646",
            "telephone_number": "407-875-3700",
            "fax_number": "407-522-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MERCY DR",
            "address_2": "SUITE 302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085646",
            "telephone_number": "407-875-3700",
            "fax_number": "407-522-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "STACY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "RN9317006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Orlando Dental PA
• South Orlando Family Practice & Medical Injury Center LLC
• South Orlando OBGYN and Pediatrics
• South Orlando Pediatrics PLLC
• South Rehabilitation Center, Inc.
• Southchase Community Pharmacy (Patients First Pharmacy)
• Southeast Medical Imaging, Services
• Southeastern Clinical Services,Inc.
• Southeastern Dental Group (Family And Cosmetic Dentistry At Vista Lakes)
• Southern Surgical Services, LLC

• Psychiatric/Mental Health Registered Nurse in Orlando, FL
• Providers in Orlando, FL by specialty
• Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.