Individual provider Active NPI

Stacey Leah Pejsa, NP

  • Family Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1093483562
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
217460 Issued in AR
Practice address
1100 N College Ave
Fayetteville, AR 72703-1944
Phone
(479) 443-4301
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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 217460 AR Primary

Addresses

Primary practice location

1100 N College Ave
Fayetteville, AR 72703-1944

Mailing address

1100 N College Ave
Fayetteville, AR 72703-1944
Phone (479) 443-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20211104000434 AR Practitioner - Nurse Practitioner 9032507496 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Francis House Nwa, Inc.Group PAC ID 0042262495, 67 clinicians

Practice addresses (Care Compare)

1233 W Poplar St
Community Clinic Rogers Medical
Rogers, AR 72756-4245
Phone (479) 636-9235

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217460ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pea Ridge Urgent Care Clinic CurrentSince Apr 1, 2024 Accepting new patients
St Francis House Nwa, Inc Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Sep 22, 2021 Accepting new patients
St Francis House Nwa, Inc CurrentSince Nov 1, 2021 Accepting new patients
St Francis House Nwa, Inc CurrentSince Nov 1, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1233 W Poplar St
Rogers, AR 72756
Phone (479) 636-9235

614 E Emma Ave
Ste 300
Springdale, AR 72764
Phone (479) 751-4898

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1093483562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEJSA",
        "first_name": "STACEY",
        "middle_name": "LEAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "217460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.