Ilya O Stagner, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2024009165 Issued in MO

Practice address

114 E South Hills Dr
Maryville, MO 64468-2659

Phone

(660) 562-4304

Fax

(660) 562-4308

NPI assigned

Oct 11, 2021

Sex

Male

Sole proprietor

Yes

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 KS, MO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Regional Health ServicesGroup PAC ID 8921917352, shared by 13 NPIs, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mosaic Medical Center - Maryville Hospital, Maryville, MO, CCN 261340
• Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Merit-based Incentive Payment System (MIPS)

Final score

87.36 of 100Reported as group

Quality

81.83

Promoting interoperability

99

Improvement activities

40

Cost

74.61

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 and National Provider Directory roles.

• Mosaic Medical Center - Maryville

  • Specialist
  • Maryville, MO
  • NPI 1184189797

  Family

  Medicare reassignment NPD
• Hiawatha Hospital Association Inc

  • Nutrition Education Nutritionist
  • Hiawatha, KS
  • NPI 1518572395
  Medicare reassignment NPD
• Informe Healthcare Il LLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1639790678

  KS, Nurse Practitioner

  Medicare reassignment NPD
• Urgent Care of Kansas

  • Urgent Care Clinic/Center
  • Gardner, KS
  • NPI 1710442975

  MO

  Medicare reassignment NPD
• Mosaic Medical Center - Maryville

  • Psychiatric Hospital Unit
  • Maryville, MO
  • NPI 1477027803
  NPD
• Hiawatha Hospital Association Inc

  • Family Medicine Physician
  • Hiawatha, KS
  • NPI 1831273044

  Nurse Practitioner

  NPD
• Mosaic Medical Center - Maryville

  • Rural Health Clinic/Center
  • Maryville, MO
  • NPI 1821562265
  NPD (past)

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

• Heartland Regional Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  Care Compare affiliation
• Mosaic Medical Center - Maryville

  • Critical Access Hospital
  • Maryville, MO
  • NPI 1265906663
  Care Compare affiliation

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1083376750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E SOUTH HILLS DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682659",
            "telephone_number": "660-562-4304",
            "fax_number": "660-562-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E SOUTH HILLS DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682659",
            "telephone_number": "660-562-4304",
            "fax_number": "660-562-4308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Utah St",
            "address_purpose": "LOCATION",
            "city": "Hiawatha",
            "state": "KS",
            "postal_code": "664342314",
            "country_code": "US",
            "telephone_number": "785-742-6422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAGNER",
        "first_name": "ILYA",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "80603",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024009165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Douglas Henry Steiner, DC
• Keri Ann Stephenson, RD, LD, CDE
• Jessica Stiens
• Trenton Stumpff, R.PH.

• Family Nurse Practitioner in Maryville, MO
• Providers in Maryville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.