Susan Vanderzyl Stafford, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

S5080 Issued in TX

Practice address

950 N 19TH St Ste 100
Abilene, TX 79601-2420

Phone

(325) 670-6370

NPI assigned

May 19, 2015

Last updated

Jan 11, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1982083200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N 19TH ST STE 100",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012420",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 19TH ST STE 100",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012420",
            "telephone_number": "325-670-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "SUSAN",
        "middle_name": "VANDERZYL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10054444",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "S5080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlette Grace Squyres, OTR
• SSKP, LLC (Touching Hearts at Home)
• Adam Victor St Cyr, LPC
• St. Cyr, LLC
• Sarah St. Cyr, M.ED., LPC
• Stages of Recovery, Inc (Stages of Recovery, Inc. Addiction Services)
• Amber Dona Staggs, LCDC-I, QMHP
• Stanley D. Turner, DDS, PC
• David P Stanley, MD
• Richard D Stanley, MD

• Colon & Rectal Surgery Physician in Abilene, TX
• Providers in Abilene, TX by specialty
• Colon & Rectal Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.