Individual provider Active NPI

Scott Allen Stickney Jr., FNP-BC

  • Family Nurse Practitioner
  • Wadsworth, OH
National Provider Identifier
1033729025
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020014684 Issued in OH
Practice address
174 Brixton Way
Wadsworth, OH 44281-6220
Phone
(330) 421-2291
NPI assigned
Aug 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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 2020014684 OH Primary

Addresses

Primary practice location

174 Brixton Way
Wadsworth, OH 44281-6220

Mailing address

174 Brixton Way
Wadsworth, OH 44281-6220
Phone (330) 421-2291

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210311002957 OH Practitioner - Nurse Practitioner 0547676777 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22610 Lorain Rd
Suite Ur
Fairview Park, OH 44126-2214
Phone (330) 421-2291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020014684OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nurse Practitioner Health Services, LLC CurrentSince Dec 22, 2024 Accepting new patients
Premium Quality NP, LLC CurrentSince Sep 27, 2021 Accepting new patients
Platinum Health and Wellness LLC Family CurrentSince Jul 1, 2024 Accepting new patients
Meritra Physicians LLC Past Accepting new patients
Access Medical Group LLC Past Accepting new patients

Locations

1186 Hadcock Rd
Brunswick, OH 44212
Phone (330) 225-3156

22610 Lorain Rd
Ste Ur
Fairview Park, OH 44126
Phone (330) 421-2291

555 Springbrook Dr
Medina, OH 44256
Phone (330) 725-3393

5155 Buehlers Dr
Ste 108
Medina, OH 44256

19530 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-7500

15400 Pearl Rd
Ste 238
Strongsville, OH 44136
Phone (440) 879-1258

Organizations & group practices 5

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": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1033729025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BRIXTON WAY",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442816220",
            "telephone_number": "330-421-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 BRIXTON WAY",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442816220",
            "telephone_number": "330-421-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "SCOTT",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "2020014684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.