Individual provider Active NPI

Shauna Stice, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1083308324
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4003368 Issued in KY
Practice address
2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone
(270) 780-0560
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 4003368 KY Primary

Addresses

Primary practice location

2724 Nashville Rd
Bowling Green, KY 42101-4000

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 781-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230623002121 KY Practitioner - Nurse Practitioner 6305204322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone 2707815111270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4003368KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jun 12, 2023 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Jun 12, 2023 Accepting new patients

Locations

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

2724 Nashville Rd
Bowling Green, KY 42101
Phone (270) 780-0560

102C Physicians Blvd
Glasgow, KY 42141
Phone (270) 651-2433

Interoperability endpoints

  • Direct secure messaging: shaunastice@ggc.allscriptsdirect.net

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": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1083308324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 NASHVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014000",
            "telephone_number": "270-780-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICE",
        "first_name": "SHAUNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4003368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.