Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hailey Dominy Stack, PA-C

Individual provider Physician Assistant · NPI 1033736764

Hailey Dominy Stack, PA-C is a Physician Assistant in Savannah, Georgia. Graduated from Lincoln Memorial University Medical Department in 2024, 2 years ago. Practices with Internal Medicine of Savannah, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Trained at
Lincoln Memorial University Medical Department
Licensed in
GA
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6413 Waters Ave Ste 102
Savannah, GA 31406-2711
Phone: (912) 349-6624
Fax: (912) 352-4728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12635 (GA)

Record details

NPI number1033736764
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 29, 2020
Last updated in NPPESJanuary 31, 2025
Certification dateJanuary 31, 2025
Mailing address6413 Waters Ave Ste 102, Savannah, GA 31406-2711

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2024 (2 years in practice)
Group practice Internal Medicine Of Savannah, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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