Individual provider Active NPI

Stacy Lynn Kracher, APRN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Honolulu, HI
National Provider Identifier
1124355003
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
717 Issued in HI
Practice address
2100 N Nimitz Hwy
Honolulu, HI 96819-2218
Phone
(808) 845-2018
Fax
(808) 845-3729
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 717 HI Primary

Addresses

Primary practice location

2100 N Nimitz Hwy
Honolulu, HI 96819-2218

Mailing address

155 Paoakalani Ave Apt 601
Honolulu, HI 96815-3703
Phone (808) 688-6947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130711000125 HI Practitioner - Certified Clinical Nurse Specialist (CNS) 9537309786 Reassigns benefits to 1 organization
I20180129002501 HI Practitioner - Nurse Practitioner 9537309786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Hawaii John a. Burns School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Empowerment ResourcesGroup PAC ID 2668710823, 8 clinicians

Practice addresses (Care Compare)

1110 University Ave
Suite 411
Honolulu, HI 96826-1508
Phone (808) 942-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen'S Medical Center CurrentSince May 17, 2013 Accepting new patients
The Queens Medical Center CurrentSince May 17, 2013 Accepting new patients
Community Empowerment Resources CurrentSince Apr 4, 2020 Accepting new patients
Advance Practice Inc Psychiatric/Mental Health, Adult Current Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1110 University Ave
Ste 411
Honolulu, HI 96826
Phone (808) 942-7800

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 4

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": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1124355003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 PAOAKALANI AVE APT 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968153703",
            "telephone_number": "808-688-6947",
            "fax_number": "808-845-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N NIMITZ HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192218",
            "telephone_number": "808-845-2018",
            "fax_number": "808-845-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRACHER",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "HI",
            "license": "717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.