Active NPI
Staying Healthy Medical Services LLC
- Preventive Medicine/Occupational Environmental Medicine Physician
- Plano, TX
National Provider Identifier
1912340720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- L0903
- Legal business name
- STAYING HEALTHY MEDICAL SERVICES LLC
- Practice address
- 4700 Dexter Dr
Suite 300
Plano, TX 75093-5294 - Phone
- (214) 501-8135
- NPI assigned
- Apr 10, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stephanie Han, M.D.
- Title
- Medical Director
- Phone
- (469) 569-7162
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | L0903 | TX | Primary |
Addresses
Primary practice location
4700 Dexter Dr
Suite 300
Plano, TX 75093-5294
Mailing address
4505 Mahogany LN
Copper Canyon, TX 75077-8546
Phone (214) 501-8135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170915000216 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 2163796046 | Practice locations: Plano, TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2185364 | Staying Healthy Medical Services | Certificate of waiver | Jun 1, 2028 |
National Provider Directory
National Provider DirectoryLocations
4700 Dexter Dr
Ste 300
Plano, TX 75093
Phone (214) 501-8135
4700 Dexter Dr
#300B
Plano, TX 75093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589587200000",
"number": "1912340720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4505 MAHOGANY LN",
"city": "COPPER CANYON",
"state": "TX",
"postal_code": "750778546",
"telephone_number": "214-501-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 DEXTER DR",
"address_2": "SUITE 300",
"city": "PLANO",
"state": "TX",
"postal_code": "750935294",
"telephone_number": "214-501-8135"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STAYING HEALTHY MEDICAL SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-10",
"last_updated": "2020-05-16",
"certification_date": "2020-05-16",
"status": "A",
"authorized_official_last_name": "HAN",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "469-569-7162",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083P0500X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "TX",
"license": "L0903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.