Individual provider Active NPI

Kari Stausmire, MD

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1912523713
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN31319 Issued in FL
Practice address
201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone
(386) 425-4165
Fax
(386) 425-7545
NPI assigned
Jun 18, 2020
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME153184 FL
Family Medicine Physician 207Q00000X TRN31319 FL Primary

Addresses

Primary practice location

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765

Mailing address

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone (386) 425-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220624002238 FL Practitioner - Family Practice 9931526845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709
Phone (386) 254-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME153184FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mediquick Urgent Care Centers Inc CurrentSince Jun 15, 2022 Accepting new patients
Halifax Healthcare Systems Inc Family Medicine CurrentSince Nov 2, 2022 Accepting new patients

Locations

201 N Clyde Morris Blvd
Ste 200
Daytona Beach, FL 32114
Phone (386) 254-4165

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

140 Pinnacles Dr
Palm Coast, FL 32164
Phone (386) 447-6615

6 Office Park Dr
Palm Coast, FL 32137
Phone (386) 445-7238

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kari.l.stausmire.1@16462.direct.athenahealth.com
  • Direct secure messaging: kari.preceptor.stausmire.1@16462.direct.athenahealth.com
  • Direct secure messaging: kari.stausmire.1@23910.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1912523713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUSMIRE",
        "first_name": "KARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME153184",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN31319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.