Jacklyn Kay Stanley, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277.005631 Issued in IL

Practice address

113 E Walnut St
Noble, IL 62868-1709

Phone

(618) 852-1395

Fax

(618) 822-4196

NPI assigned

Oct 4, 2021

Last updated

Oct 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Katie Stanley Other name

Medicare fee-for-service enrollment

Enrolled in IL

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of ClayGroup PAC ID 0042101982, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clay County Hospital Hospital, Flora, IL, CCN 141351

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstanley406706@direct-ehr-ssmhc.com

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.

• County of Clay

  dba CCH Medical Clinic

  • Rural Health Clinic/Center
  • Flora, IL
  • NPI 1811946411
  Medicare reassignment Care Compare group NPD
• Ink & Ivy Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Noble, IL
  • NPI 1023948973
  NPD Authorized official
• County of Clay

  dba Clay County Hospital

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  NPD
• County of Clay

  dba CCH Pharmacy

  • Community/Retail Pharmacy
  • Flora, IL
  • NPI 1235990276
  NPD
• County of Clay

  • Rural Health Clinic/Center
  • Clay City, IL
  • NPI 1871950550
  NPD (past)

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

• County of Clay

  dba Clay County Hospital

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  Care Compare affiliation

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1073285482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E WALNUT ST",
            "city": "NOBLE",
            "state": "IL",
            "postal_code": "628681709",
            "telephone_number": "618-514-8599",
            "fax_number": "618-822-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E WALNUT ST",
            "city": "NOBLE",
            "state": "IL",
            "postal_code": "628681709",
            "telephone_number": "618-852-1395",
            "fax_number": "618-822-4196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 S Main St",
            "address_purpose": "LOCATION",
            "city": "Dieterich",
            "state": "IL",
            "postal_code": "624241128",
            "country_code": "US",
            "telephone_number": "618-852-1395",
            "fax_number": "618-822-4196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "939 Sunset Rd SW",
            "address_purpose": "LOCATION",
            "city": "Clay City",
            "state": "IL",
            "postal_code": "628241113",
            "country_code": "US",
            "telephone_number": "686-662-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "JACKLYN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277.005631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "STANLEY",
            "credential": "APRN, PMHNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Noble, IL
• Providers in Noble, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.