Individual provider Active NPI

Stacy Horvath

  • Psychiatric/Mental Health Nurse Practitioner
  • Warren, OH
National Provider Identifier
1073284600
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0033201 Issued in OH
Practice address
1716 North Rd SE
Warren, OH 44484-2907
Phone
(330) 539-3200
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0033201 OH Primary
Registered Nurse 163W00000X RN.453166 OH

Addresses

Primary practice location

1716 North Rd SE
Warren, OH 44484-2907

Mailing address

11565 Bloom Rd
Garrettsville, OH 44231-9236
Phone (330) 221-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230928003585 OH Practitioner - Nurse Practitioner 8123472818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Water Counseling and Recovery LLCGroup PAC ID 8527487750, 16 clinicians

Practice addresses (Care Compare)

1716 N Rd SE
Warren, OH 44484-2907
Phone (330) 539-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0033201OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Water Counseling and Recovery, LLC CurrentSince Sep 1, 2023 Accepting new patients
Open Water Counseling and Recovery, LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

1716 North Rd SE
Warren, OH 44484
Phone (330) 399-9776

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/openwatercounseling/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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1073284600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11565 BLOOM RD",
            "city": "GARRETTSVILLE",
            "state": "OH",
            "postal_code": "442319236",
            "telephone_number": "330-221-1833",
            "fax_number": "330-529-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 NORTH RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842907",
            "telephone_number": "330-539-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORVATH",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2024-06-21",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0033201",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.453166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.