Staci D Burrell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201126 Issued in NC

Practice address

3125 Springbank LN Ste a
Charlotte, NC 28226-3379

Phone

(704) 752-9346

Fax

(704) 235-1666

NPI assigned

Jun 23, 2006

Last updated

Jul 30, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minuteclinic Diagnostic South Carolina LLC

  • Family Nurse Practitioner
  • Simpsonville, SC
  • NPI 1447420815
  Medicare reassignment NPD
• New Hope Carolinas

  • Psychiatric Residential Treatment Facility
  • Rock Hill, SC
  • NPI 1831114735
  NPD (past)
• York Emergency Physicians

  • Emergency Care Clinic/Center
  • Rock Hill, SC
  • NPI 1700828084
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1114953106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 SPRINGBANK LN STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263379",
            "telephone_number": "803-517-8478",
            "fax_number": "704-235-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 SPRINGBANK LN STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263379",
            "telephone_number": "704-752-9346",
            "fax_number": "704-235-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Sedgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297322315",
            "country_code": "US",
            "telephone_number": "803-328-9300 x5173",
            "fax_number": "803-327-2179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRELL",
        "first_name": "STACI",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "1143",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bene Burpee
• Meghan Burr, PT, DPT
• Taylor Burr
• Lillian Catiria Burrafato, PA
• Beverly Christine Burrell, LCMHCA
• Stuart Heinrich Burri, M.D.
• Tammathy Burris Sadler
• Metta Nicole Pittman Burris, DNP, RN, AGPCNP-BC
• Taylor Burris, MSW, LCSWA
• Tralyn Burris

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.