Individual provider Active NPI

Stacey Jeanne Pappas, M.D.

  • Family Medicine Physician
  • Bunnell, FL
National Provider Identifier
1124129358
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME93828 Issued in FL
Practice address
42 Caroline St Unit a
Bunnell, FL 32110-8904
Phone
(386) 425-4470
Fax
(386) 425-4471
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME93828 FL
Sports Medicine (Family Medicine) Physician 207QS0010X MD14404 RI
Family Medicine Physician 207Q00000X MD14404 RI
Family Medicine Physician 207Q00000X ME93828 FL Primary

Addresses

Primary practice location

42 Caroline St Unit a
Bunnell, FL 32110-8904

Mailing address

42 Caroline St Unit a
Bunnell, FL 32110-8904
Phone (386) 425-4470

Other identifiers 1

IdentifierTypeStateIssuer
274079600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121000640 FL Practitioner - Family Practice 0446279327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Connecticut School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

309 Palm Coast Pkwy NE
Palm Coast, FL 32137-3886
Phone (386) 756-0591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME93828FLMDFamily Medicine Physician
MD14404RIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Apr 28, 2025 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Apr 28, 2025 Accepting new patients
Halifax Healthcare Systems Inc Family Medicine Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

309 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 445-7073

Organizations & group practices 3

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1124129358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CAROLINE ST UNIT A",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321108904",
            "telephone_number": "386-425-4470",
            "fax_number": "386-425-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CAROLINE ST UNIT A",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321108904",
            "telephone_number": "386-425-4470",
            "fax_number": "386-425-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "STACEY",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME93828",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "RI",
            "license": "MD14404",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD14404",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274079600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bunnell, FL

Sources for this page

Verify at the official NPI Registry.