Individual provider Active NPI

Stacey Lynn Cole, NP

  • Family Nurse Practitioner
  • Escanaba, MI
National Provider Identifier
1063768422
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704213234 Issued in MI
Practice address
3409 Ludington St Ste 104
Escanaba, MI 49829
Phone
(906) 786-8343
NPI assigned
Aug 3, 2012
Last updated
Aug 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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 4704213234 MI Primary

Addresses

Primary practice location

3409 Ludington St Ste 104
Escanaba, MI 49829

Mailing address

3409 Ludington St Ste 104
Escanaba, MI 49829-4213
Phone (906) 786-8343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120926000611 MI Practitioner - Nurse Practitioner 3375792856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

3409 Ludington St
Suite 104
Escanaba, MI 49829-4213
Phone (906) 786-8343

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704213234MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Oct 11, 2016 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Oct 11, 2016 Accepting new patients
St. Francis Hospital CurrentSince Aug 6, 2018 Accepting new patients
Schoolcraft Memorial Hospital CurrentSince Aug 27, 2012 Accepting new patients
St. Francis Hospital Current Accepting new patients
St Francis Hospital CurrentSince Aug 6, 2018 Accepting new patients
St Francis Hospital Past Accepting new patients

Locations

3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343

2002 Minneapolis Ave
Gladstone, MI 49837
Phone (906) 428-1796

7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

Organizations & group practices 7

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 & 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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1063768422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST STE 104",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498294213",
            "telephone_number": "906-786-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST STE 104",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-786-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704213234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.