Stacey S Hodges, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN105802 Issued in TN

Practice address

9 Physicians Dr
Jackson, TN 38305

Phone

(731) 661-0086

Fax

(731) 661-0281

NPI assigned

Oct 7, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104814805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11567",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38308",
            "telephone_number": "731-661-0086",
            "fax_number": "731-661-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-0086",
            "fax_number": "731-661-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "STACEY",
        "middle_name": "S",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "RN105802",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN 7203",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "RN105802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3902598",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julian Bruce Hinton Jr., DPH
• Stephen Hjerpe, DO
• Megan Hobgood
• Edward Hockaday, MD
• Sara Elizabeth Hodge
• Susan Jane Hodges, PT, MLDT
• Nathan John Hoeldtke, M.D.
• Marybeth Hogan, RN
• Terry Constance Hogan, MS
• Charlotte Ann Holden, RDH

• Acute Care Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.