Individual provider Active NPI

Stacey V Pepper, CRNA

  • Certified Registered Nurse Anesthetist
  • Decatur, AL
National Provider Identifier
1104114818
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-108573 Issued in AL
Practice address
1201 7TH St SE
Decatur, AL 35601-3337
Phone
(256) 341-2000
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-108573 AL Primary

Addresses

Primary practice location

1201 7TH St SE
Decatur, AL 35601-3337

Mailing address

425 Cloverleaf Dr
Athens, AL 35611-4423
Phone (256) 232-7341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000133 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062681711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens and Limestone County Healthcare AuthorityGroup PAC ID 3870641863, 23 clinicians

Practice addresses (Care Compare)

700 W Market St
Athens, AL 35611-2457
Phone (256) 233-9292

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athens and Limestone County Healthcare Authority Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2014 Accepting new patients
Anesthesia Services of Decatur PC CurrentSince Apr 14, 2018 Accepting new patients

Locations

700 W Market St
Athens, AL 35611
Phone (256) 233-9292

22454 US Highway 72
Athens, AL 35613
Phone (256) 233-9292

1201 7th St SE
Decatur, AL 35601
Phone (256) 341-2000

1122 14th Ave SE
Decatur, AL 35601
Phone (256) 560-2890

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1104114818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CLOVERLEAF DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356114423",
            "telephone_number": "256-232-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 7TH ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013337",
            "telephone_number": "256-341-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "STACEY",
        "middle_name": "V",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-108573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.