John Joseph Stacy, MLTDSW, CAC-1

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087738 Issued in MI

Practice address

2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552

Phone

(734) 222-9501

Fax

(734) 971-2487

NPI assigned

Mar 2, 2007

Last updated

Jul 8, 2007By 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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Ohio Office of Budget and Management State AccountingGroup PAC ID 0143133181, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• State of Ohio Office of Budget and Management State Accounting

  dba Summit Behavioral Healthcare

  • Psychiatric Hospital
  • Cincinnati, OH
  • NPI 1023082716
  Medicare reassignment Care Compare group NPD
• State of Ohio Office of Budget and Management State Accounting

  dba Ohio Veterans Home

  • Nursing Facility/Intermediate Care Facility
  • Sandusky, OH
  • NPI 1790732576
  NPD
• State of Ohio Office of Budget and Management, State Accounting

  dba Central Ohio Behavioral Healthcare CSN

  • Case Management Agency
  • Hilliard, OH
  • NPI 1538134739
  NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912035627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "address_2": "PO BOX 915",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 E ELLSWORTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082552",
            "telephone_number": "734-222-9501",
            "fax_number": "734-971-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MLTDSW, CAC-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Roger Stacey, NP
• Tara Stacey, OD
• William Charles Stacey, MD
• Casey J Stach, M.A.
• Michael Stack, EP
• Stadium Opticians, Inc.
• Stadium Opticians, Inc.
• Stadium Opticians, Inc.
• Leonard Louis Stadtmiller, R.PH.
• Emma Stafne

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.