Individual provider Active NPI

Jessica Stodieck, AGACNP

  • Acute Care Nurse Practitioner
  • Burleson, TX
National Provider Identifier
1073056370
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP132562 Issued in TX
Practice address
209 Old Highway 1187
Burleson, TX 76028-0281
Phone
(682) 268-6700
Fax
(682) 268-6701
NPI assigned
Nov 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132562 TX
Acute Care Nurse Practitioner 363LA2100X AP132562 TX Primary

Addresses

Primary practice location

209 Old Highway 1187
Burleson, TX 76028-0281

Mailing address

209 Old Highway 1187
Burleson, TX 76028-0281
Phone (682) 268-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170524002211 TX Practitioner - Nurse Practitioner 2769759646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.59 of 100Reported as group
Quality
74.14
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132562TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huguley Medical Associates CurrentSince Nov 1, 2024 Accepting new patients
Fort Worth Heart, P.a. CurrentSince Feb 8, 2017 Accepting new patients

Locations

11797 South Fwy
Ste 242
Burleson, TX 76028
Phone (817) 568-1981

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

209 Old Highway 1187
Burleson, TX 76028
Phone (682) 268-2700

1900 Mistletoe Blvd
Ste 100
Ft Worth, TX 76104
Phone 8173381300236

1339 East St
Graham, TX 76450
Phone (940) 264-2625

1312 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-1855

Interoperability endpoints

  • Direct secure messaging: jstodieck659997@adventhealth.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/18287/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1073056370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "682-268-6700",
            "fax_number": "682-268-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 OLD HIGHWAY 1187",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280281",
            "telephone_number": "682-268-6700",
            "fax_number": "682-268-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODIECK",
        "first_name": "JESSICA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132562",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.