Individual provider Active NPI

Stacy Lynn Rosebrook, APRN, NNP-BC

  • Neonatal Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1013248723
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP118958 Issued in TX
Practice address
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone
(817) 250-3120
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X AP118958 TX Primary
Neonatal Intensive Care Registered Nurse 163WN0002X 604225 TX

Addresses

Primary practice location

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122

Mailing address

1008 Paradise Pkwy
Poolville, TX 76487-1529
Phone (682) 521-2299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20210927000078 TX Practitioner - Nurse Practitioner 4082011549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
604225TXMDNeonatal Intensive Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Texas Billing, Inc. CurrentSince May 28, 2021 Accepting new patients

Locations

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

3500 Gaston Ave
Dallas, TX 75246

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1013248723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 PARADISE PKWY",
            "city": "POOLVILLE",
            "state": "TX",
            "postal_code": "764871529",
            "telephone_number": "682-521-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBROOK",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "APRN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP118958",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "TX",
            "license": "604225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.