Stacy Wayne Dennis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA040 Issued in MS

Practice address

46 SGT Prentiss Dr
Suite 103
Natchez, MS 39120-4792

Phone

(601) 442-9654

Fax

(601) 442-9790

NPI assigned

Jul 7, 2006

Last updated

Apr 9, 2008By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: sdennis@direct.mhg.com

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1902838162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 SGT PRENTISS DR",
            "address_2": "SUITE 103",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204792",
            "telephone_number": "601-442-9654",
            "fax_number": "601-442-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SGT PRENTISS DR",
            "address_2": "SUITE 103",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204792",
            "telephone_number": "601-442-9654",
            "fax_number": "601-442-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "STACY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Natchez, MS
• Providers in Natchez, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.