Stacey Hollaway, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35-062821H Issued in OH

Practice address

4810 Munson St NW
Canton, OH 44718-3613

Phone

(330) 499-3377

NPI assigned

Apr 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Northeastern Ohio University College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stark County Medical Group IncGroup PAC ID 6709770779, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Home Health & Hospice LLC Home health agency, Canton, OH, CCN 367256
• Advantage Home Health Services, Inc Home health agency, North Canton, OH, CCN 368248
• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shollaway@starkcountymedicalgroup.medentdirect.com

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.

• Stark County Medical Group, Inc.

  • Internal Medicine Physician
  • Canton, OH
  • NPI 1427068634
  Medicare reassignment Care Compare group NPD
• Stark County Medical Group, Inc.

  • Legal Medicine
  • Canton, OH
  • NPI 1174610398
  NPD (past)

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

• Advantage Home Health Services, Inc

  • Home Health Agency
  • North Canton, OH
  • NPI 1710141163
  Care Compare affiliation
• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794
  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation
• Mercy Medical Center Home Health & Hospice LLC

  • Home Health Agency
  • Canton, OH
  • NPI 1073972550
  Care Compare affiliation
• Orrville Hospital Foundation

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1922064906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8062 N NICKELPLATE ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446419543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183613",
            "telephone_number": "330-499-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAWAY",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-062821H",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-062821H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0888615",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Angelica Holden, MD
• Carina Holdsworth, PHARMD
• Susan L. Hollada, L.S.W.
• Ivory Hollamon
• Brenda Holland, PCC
• Jacqueline Francis Hollcraft, P.A.
• Denise Michelle Hollenbach
• Marisha Lynn Holman-Mitchell, OCPSA, LPC, LCDCIII
• Carmen Holmes, CT
• Iris Holston

• Internal Medicine Physician in Canton, OH
• Providers in Canton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.