Individual provider Active NPI

Pamela Stang, APRN

  • Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1023576337
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3013204 Issued in KY
Practice address
1221 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-4000
Fax
(859) 258-6203
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3013204 KY
Nurse Practitioner 363L00000X 3013204 KY Primary

Addresses

Primary practice location

1221 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other practice location 1

225 Falcon Dr
MT Sterling, KY 40353-9792
Phone (859) 497-5000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190612002859 KY Practitioner - Nurse Practitioner 8628301249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

Hospital & facility affiliations

  • Saint Joseph Mount Sterling Hospital, Mount Sterling, KY, CCN 180064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner CurrentSince Jul 11, 2019 Accepting new patients
New Lexington Clinic, PSC CurrentSince Apr 17, 2023 Accepting new patients
New Lexington Clinic PSC CurrentSince Apr 17, 2023 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

225 Falcon Dr
Mt Sterling, KY 40353
Phone (859) 497-5000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1023576337",
    "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": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4000",
            "fax_number": "859-258-6203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Falcon Dr",
            "address_purpose": "LOCATION",
            "city": "MT Sterling",
            "state": "KY",
            "postal_code": "403539792",
            "country_code": "US",
            "telephone_number": "859-497-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANG",
        "first_name": "PAMELA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "3013204",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.