Stacie Lynn Ricketts-McCook, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN185141 Issued in GA

Practice address

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085

Phone

(678) 604-5901

NPI assigned

Nov 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacie.ricketts-mccook@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment NPD
• Piedmont Athens Hospitalist Physicians LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1578079000
  Medicare reassignment NPD
• Piedmont Hospitalist Physicians LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1548219660
  Medicare reassignment NPD
• Comprehensive Orthopedics & Musculoskeletal Care LLC

  • Orthopaedic Surgery Physician
  • Wallingford, CT
  • NPI 1790844330
  Medicare reassignment NPD
• Piedmont Athens Specialty Care LLC

  • Cardiovascular Disease Physician
  • Athens, GA
  • NPI 1184130627
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1053956045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT STE 200",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-5901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "863 N Main Street Ext Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "064922434",
            "country_code": "US",
            "telephone_number": "203-265-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKETTS-MCCOOK",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "10235",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN185141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyoo Ricard, MD
• Qunisha T Richard, RBT
• Kendra Sherrice Richardson
• Selina Maria Richardson, RN, IBCLC
• Jewel Richmond
• Kamal Dante Riggins
• Karen Denise Rigsby, NP
• Bria Riley
• Desiree Riley, FNP
• David T. Rink

• Adult Health Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.