Stacey M Anderson, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3009247 Issued in KY

Practice address

1225 S Broadway Ste 201
Lexington, KY 40504-2701

Phone

(859) 258-4950

Fax

(859) 258-4618

NPI assigned

Mar 18, 2015

Last updated

Dec 2, 2024By 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

Other names 1

• Stacey Muir Wilson Former name

Medicare fee-for-service enrollment

Enrolled in KY

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Regional Physician Practices LLCGroup PAC ID 9739337569, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clark Regional Medical Center Hospital, Winchester, KY, CCN 180092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19475/brand/10/csg/41/fhir/r4
• Direct secure messaging: stacey.anderson.1@19475.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clark Regional Physician Practices LLC

  dba Centerpoint Family Medicine - Mt. Sterling

  • Rural Health Clinic/Center
  • Mt Sterling, KY
  • NPI 1780356253
  Medicare reassignment Care Compare group NPD
• Bourbon Physician Practice LLC

  • Family Medicine Physician
  • Paris, KY
  • NPI 1790195717
  Medicare reassignment NPD
• Meadowview Physician Practice, LLC

  • Otolaryngology Physician
  • Maysville, KY
  • NPI 1760893275

  Nurse Practitioner

  Medicare reassignment NPD
• Bourbon Physician Practice LLC

  dba Carlisle Clinic

  • Rural Health Clinic/Center
  • Carlisle, KY
  • NPI 1356689079

  Family

  NPD
• Bourbon Physician Practice LLC

  dba Bluegrass Family Clinic

  • Rural Health Clinic/Center
  • Paris, KY
  • NPI 1962111716
  NPD
• Clark Regional Physician Practices, LLC

  dba Centerpoint Podiatry - Winchester

  • Durable Medical Equipment & Medical Supplies
  • Winchester, KY
  • NPI 1114282605

  Nurse Practitioner

  NPD
• Meadowview Physician Practice LLC

  dba Meadowview General Surgery

  • Surgery Physician
  • Maysville, KY
  • NPI 1356592612

  Nurse Practitioner

  NPD
• Meadowview Physician Practice LLC

  dba Meadowview Internal Medicine & Pediatric Associates

  • Rural Health Clinic/Center
  • Maysville, KY
  • NPI 1952152530
  NPD
• Kentucky Hospital, LLC

  dba Clark Regional Medical Center

  • General Acute Care Hospital
  • Winchester, KY
  • NPI 1811213994
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kentucky Hospital, LLC

  dba Clark Regional Medical Center

  • General Acute Care Hospital
  • Winchester, KY
  • NPI 1811213994
  Care Compare affiliation

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1013300896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S BROADWAY STE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4950",
            "fax_number": "859-258-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009247",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3009247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "WILSON",
            "middle_name": "MUIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie M Anderson, AGACNP-BC
• Natalie Michelle Anderson, R.N.
• Rachel Haley Anderson
• Ryan Jeffery Anderson, M.D.
• Shannon Anderson, APRN
• Susan Melina Anderson, APRN
• Tayler Anderson, APRN
• Kirsti Anderssen, M.D.
• Reynold Andika, MD
• Andilou LLC

• Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.