Stacey Maltman, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20093 Issued in TN

Practice address

9051 Executive Park Dr Ste 500
Knoxville, TN 37923-4632

Phone

(865) 337-7793

Fax

(865) 240-3539

NPI assigned

Jul 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Lincoln Memorial University Medical Department, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Maltman Medical Center LLCGroup PAC ID 6204124548, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: stacey.maltman.1@14521.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14521/brand/1/csg/1/fhir/r4

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.

• Maltman Medical Center LLC

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1225586878
  Medicare reassignment Care Compare group Authorized official
• Stephen D. Pershing MD PLLC

  • Internal Medicine Physician
  • Vonore, TN
  • NPI 1104159417
  NPD (past)
• Victory Treatment Program, LLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1508320623
  NPD (past)

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

{
    "created_epoch": "1437264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1043694029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 EXECUTIVE PARK DR STE 500",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234632",
            "telephone_number": "865-337-7793",
            "fax_number": "865-240-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 EXECUTIVE PARK DR STE 500",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234632",
            "telephone_number": "865-337-7793",
            "fax_number": "865-240-3539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Old N. Kentucky Street",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "TN",
            "postal_code": "37763",
            "country_code": "US",
            "telephone_number": "865-248-8728",
            "fax_number": "865-248-8782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALTMAN",
        "first_name": "STACEY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-19",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019748",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Faith Malone, RN
• Stephen K Malone, DMD
• Teresa Malone, FNP
• Valerie Malone, R.N.
• Maltman Medical Center LLC
• Christopher R Malz
• Management Solutions LLC
• Gerald L Mancebo, MD
• Gregory John Mancini, MD
• Matthew L Mancini, M.D.

• Family Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.