Frederick Stack
Specialist

Address: 1821 N Trekell Rd, Suite 6, Casa Grande, AZ 85222-1705
Phone: 5204211122

Frederick Stack (NPI# 1548256977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1548256977
Entity Type Individual
Full Name Frederick Stack
Credential MD
Gender Male
Practice Address 1821 N Trekell Rd
Suite 6
Casa Grande
AZ 85222-1705
Practice Telephone 5204211122
Practice Fax Number 5204210751
Mailing Address 1821 N Trekell Rd
Suite 6
Casa Grande
AZ 85222-1705
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2005-09-21
Last Update Date 2007-10-18

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 174400000X Specialist Other Service Providers 24459 AZ

Other Provider Identifier

State Identifier Issuer Type Code
AZ 110208816 OTHER MEDICARE RAILROAD
AZ 436693002 MEDICAID
AZ AZ0866740 OTHER BLUE CROSS BLUEE SHIELD

Physician Overview

NPI 1548256977
PAC ID by PECOS 9638149230
Professional Enrollment ID I20040730000095
Full Name Frederick R Stack
Gender M
Credential MD
Medical School UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year 1991
Primary Specialty INTERNAL MEDICINE
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
030002 BANNER - UNIVERSITY MEDICAL CENTER PHOENIX
030130 BANNER IRONWOOD MEDICAL CENTER

Office Location

Street Address 1821 N TREKELL RD
SUITE 6
City CASA GRANDE
State AZ
Zip Code 85222-1705

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528513751 Pete Vavages Peer Specialist 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2016-08-17
1902256035 Nicole Moraga Case Manager/Care Coordinator 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2016-06-20
1982063905 Francisca Federico Case Manager/Care Coordinator 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2016-02-18
1467817825 Jack Wang Peer Specialist 1821 N Trekell Rd, Ste 7, Casa Grande, AZ 85122-1705 2015-12-29
1043675408 James Zbell Registered Nurse 1821 N Trekell Rd, Ste 7, Casa Grande, AZ 85122-1705 2015-12-29
1982069340 Andres L Salazar Peer Specialist 1821 N Trekell Rd, Ste 7, Casa Grande, AZ 85122-1705 2015-12-29
1619348885 Milissa A Baugh Counselor 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2015-10-14
1285004135 Frances Archuleta Counselor 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2015-10-05
1144602988 Kathy Brock Registered Nurse 1821 N Trekell Rd, Suite 7, Casa Grande, AZ 85122-1705 2015-06-28
1811389257 Carrie Freeland Registered Nurse 1821 N Trekell Rd, Casa Grande, AZ 85122-1705 2015-02-23
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699184093 Hemali Paton Pharmacist 1741 E. Florence Blvd., Casa Grande, AZ 85222 2014-08-11
1023249893 Krista Marie Nielsen Nurse Practitioner 1676 E. Mcmurray Blvd, Cgrmc Urgent Care, Casa Grande, AZ 85222 2009-07-28
1639333479 Villago Marketplace Dental Care PC Dentist 2876 N Pinal Ave, Suite 4, Casa Grande, AZ 85222 2008-07-10
1487811790 Ashley Vander Weel Dietitian, Registered 351 N Peart Rd, Apt 325, Casa Grande, AZ 85222 2008-05-22
1205022787 Linda C Cassidy Registered Nurse 2730 North Trekell Road, Casa Grande Union High School, Casa Grande, AZ 85222 2007-09-19
1104021476 Jeremy Wade Cull Dentist 1876 E Sabin Drive Suite #18, Casa Grande, AZ 85222 2007-06-18
1841404852 New Horizon Youth Homes, Inc. Residential Treatment Facility, Emotionally Disturbed Children 467 East Dragon Springs Dr, Casa Grande, AZ 85222 2007-05-09
1013137827 Namninder S Grn Dentist 1677 E Florence Blvd, #24, Casa Grande, AZ 85222 2007-04-26
1528189529 Jewell Lavoo Registered Nurse 129 N Arizola Rd, Casa Grande, AZ 85222 2007-04-03
1922148089 Martha Dawn Jones-baer Registered Nurse 1220 E. Kortsen Dr, Cactus Middle School, Casa Grande, AZ 85222 2007-02-07
Find all providers in zip 85222

Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588054274 Progressive Pain Management Specialist 1653 E Mcmurray Blvd Ste 141, Casa Grande, AZ 85122-5934 2015-02-02
1619066156 John Grover Russell Specialist 8188 W Bartlett Rd, Casa Grande, AZ 85222-7336 2006-10-12
1710945266 Az-tech Radiology & Open Mri Specialist 1669 E Mcmurray Blvd, Casa Grande, AZ 85222-6010 2006-05-03
1225009350 Jean Letarte Specialist 1041 N Arizola Rd, Casa Grande, AZ 85222-6003 2006-01-27
1720596935 Alliance Oncology of Arizona, LLC Specialist 1281 E Cottonwood Ln, Casa Grande, AZ 85122-2949 2018-01-22
1881901031 Teresa Hanson Specialist 220 W Kortsen Rd, Casa Grande, AZ 85122-5910 2010-09-09
1588871552 Cottonwood Medical Center,ltd. Specialist 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 2007-05-17
1255545703 Cancer Treatment Services Arizona LLC Specialist 1876 E Sabin Dr, Casa Grande, AZ 85122-6197 2007-05-10
1669512638 Cynthia Gutierres-check Specialist 1362 N Casa Grande Ave, Casa Grande, AZ 85222-2648 2007-02-07
1922164714 Helen R Ross Specialist 1890 E Florence Blvd, Suite 4, Casa Grande, AZ 85122-5642 2006-12-28
Find all providers in CASA GRANDE

Competitor

Search similar providers

City CASA GRANDE
Zip Code 85222

Improve Information

Please comment or provide details below to improve the information on Frederick Stack.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches