Individual provider Active NPI

Stacey Ann Starsman, CNM

  • Advanced Practice Midwife
  • Nags Head, NC
National Provider Identifier
1053765917
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
596 Issued in NC
Practice address
4917 S Croatan Hwy
Nags Head, NC 27959-8811
Phone
(252) 449-2100
NPI assigned
Apr 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 596 NC Primary

Addresses

Primary practice location

4917 S Croatan Hwy
Nags Head, NC 27959-8811

Mailing address

4917 S Croatan Hwy
Nags Head, NC 27959-8811
Phone (252) 449-2100

Other practice location 1

1101 Madison Plz
Ste 201
Chesapeake, VA 23320-5179
Phone (757) 547-2322

Other names 1

  • Stacey Ann Keller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
596NCMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1053765917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598811",
            "telephone_number": "252-449-2100",
            "fax_number": "252-449-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598811",
            "telephone_number": "252-449-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Madison Plz",
            "address_2": "STE 201",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233205179",
            "country_code": "US",
            "telephone_number": "757-547-2322",
            "fax_number": "757-547-9439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARSMAN",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KELLER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.