Individual provider Active NPI

Heather Nicole Stark, FNP-C

  • Family Nurse Practitioner
  • Decatur, TX
National Provider Identifier
1023748241
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1084138 Issued in TX
Practice address
2451 S. FM, Suite 300
Decatur, TX 76234
Phone
(940) 626-8008
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1084138 TX Primary

Addresses

Primary practice location

2451 S. FM, Suite 300
Decatur, TX 76234

Mailing address

2451 S FM 51 Ste 300
Decatur, TX 76234-3861
Phone (940) 531-2265

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
I20220727000423 TX Practitioner - Nurse Practitioner 0749662591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Wise Obstetrics and Gynecology PAGroup PAC ID 1658270327, 3 clinicians

Practice addresses (Care Compare)

2451 S FM
51 Suite 300
Decatur, TX 76234-3861
Phone (940) 626-8008

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Obstetrics & Gynecology PA CurrentSince Oct 15, 2023 Accepting new patients

Locations

2451 S FM 51
Ste 300
Decatur, TX 76234
Phone (940) 626-8008

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.

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": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1023748241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 S FM 51 STE 300",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343861",
            "telephone_number": "940-531-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S. FM, SUITE 300",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-626-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2024-03-01",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1084138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.