Deborah Lou Stuck, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14377 Issued in SC

Practice address

880 W Moultrie St
Suite 200
Winnsboro, SC 29180-2411

Phone

(803) 635-6487

Fax

(803) 635-6089

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Fairfield Medical Associates, LLC

  • Rural Health Clinic/Center
  • Winnsboro, SC
  • NPI 1184737892

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairfield Medical Associates, LLC

  • Rural Health Clinic/Center
  • Winnsboro, SC
  • NPI 1184737892

  Family Medicine, SC

  Medicare reassignment NPD
• Physician'S Pain and Spine Center, LLC

  • Interventional Pain Medicine Physician
  • West Coumbia, SC
  • NPI 1336475573
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1912913435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1218",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291805218",
            "telephone_number": "803-635-6487",
            "fax_number": "803-635-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W MOULTRIE ST",
            "address_2": "SUITE 200",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291802411",
            "telephone_number": "803-635-6487",
            "fax_number": "803-635-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "DEBORAH",
        "middle_name": "LOU",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "14377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143776",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bertha P Snow
• South Carolina CVS Pharmacy LLC
• South Carolina Em-I Medical Services PC
• State of South Carlina
• Kimberly Speaks Steele
• Julie Thach
• The Community Health Foundation of Fairfield County
• Tara Tolbert
• Trans-Med Services, Inc.
• Marianna Cristina Wagner, PHARMD

• All providers in Winnsboro, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.