Organization Active NPI

Staying Healthy Medical Services LLC

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Plano, TX
National Provider Identifier
1912340720
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
L0903 Issued in TX
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

Updated by the provider on May 16, 2020

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20170915000216 TX Part B Supplier - Mass Immunization (Roster Biller Only) 2163796046 Practice locations: Plano, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2185364Staying Healthy Medical Services4700 Dexter Dr Suite 300, Plano, TX 75093Certificate of waiverJun 1, 2028

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.