Stacy Jo Klass, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA12426 Issued in OH

Practice address

1005 Bellefontaine Ave
Suite 100
Lima, OH 45804-2851

Phone

(419) 227-5298

Fax

(419) 227-5879

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

Yes

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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Putnam Office of Auditor 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• County of Putnam Office of Auditor

  • Adult Health Nurse Practitioner
  • Ottawa, OH
  • NPI 1831602119

  OH

  Medicare reassignment Care Compare group NPD
• County of Putnam Office of Auditor

  • Nursing Care Agency
  • Ottawa, OH
  • NPI 1902802481
  Care Compare group NPD (past)
• County of Putnam Office of Auditor

  • Community Based Hospice Care Agency
  • Ottawa, OH
  • NPI 1972509024
  Care Compare group NPD (past)
• County of Putnam Office of Auditor

  • Ambulance
  • Glandorf, OH
  • NPI 1194770248
  Care Compare group
• County of Putnam Office of Auditor

  • Public Health or Welfare Agency
  • Ottawa, OH
  • NPI 1700813920
  Care Compare group
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1003196114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 COMMERCE PKWY",
            "address_2": "SUITE 101",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044040",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BELLEFONTAINE AVE",
            "address_2": "SUITE 100",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042851",
            "telephone_number": "419-227-5298",
            "fax_number": "419-227-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLASS",
        "first_name": "STACY",
        "middle_name": "JO",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA12426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053941",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Nichole Kirk
• Courtney Marie Kirk
• Kelly Kirk, CCP
• Eric Steven Kirschner, M.D.
• Mackenzie Kiss
• Brian James Klausing, PA
• Kaycie Klausing, PA-C
• Mathias Klausing, RN
• Lauren Klees
• Trisha M Kleman, CNP

• All providers in Lima, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.