Stacey Marie Burdett, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

214369 Issued in MT

Practice address

126 6TH Ave SW
Ronan, MT 59864-2600

Phone

(406) 676-3600

Fax

(406) 676-3738

NPI assigned

Apr 7, 2023

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MT

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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Community HospitalGroup PAC ID 5496659567, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Partners in Home Care Inc Home health agency, Missoula, MT, CCN 277032
• St Luke Community Hospital Hospital, Ronan, MT, CCN 271325
• Community Medical Center Hospital, Missoula, MT, CCN 270023

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St. Lukes Community Hospital

  dba St. Luke Community Clinic St. Ignatius

  • Rural Health Clinic/Center
  • St Ignatius, MT
  • NPI 1306911169
  Medicare reassignment Care Compare group NPD
• St Lukes Community Hospital

  • Critical Access Hospital
  • Ronan, MT
  • NPI 1336213446
  Medicare reassignment
• St Lukes Community Hospital

  dba St. Luke Community Covenient Care Clinic

  • Urgent Care Clinic/Center
  • Ronan, MT
  • NPI 1154566271
  NPD
• St Lukes Community Hospital

  dba St. Luke Community Specialty Clinic

  • Certified Registered Nurse Anesthetist
  • Ronan, MT
  • NPI 1518663608
  NPD
• St. Lukes Community Hospital

  dba St. Luke Community Clinic Polson

  • Rural Health Clinic/Center
  • Polson, MT
  • NPI 1184785420
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Partners in Home Care, Inc.

  • Home Health Agency
  • Missoula, MT
  • NPI 1629135447
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  dba Community Medical Center

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation
• St Lukes Community Hospital

  • Critical Access Hospital
  • Ronan, MT
  • NPI 1336213446
  Care Compare affiliation

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1073208757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42543 PARK CIRCLE DR",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598607533",
            "telephone_number": "406-360-4263",
            "fax_number": "406-883-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 6TH AVE SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642600",
            "telephone_number": "406-676-3600",
            "fax_number": "406-676-3738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 6 Tracts Way",
            "address_purpose": "LOCATION",
            "city": "St Ignatius",
            "state": "MT",
            "postal_code": "598657784",
            "country_code": "US",
            "telephone_number": "406-745-2781",
            "fax_number": "406-745-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETT",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "75899",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "214369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Ronan, MT
• Providers in Ronan, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.