Stacy Holley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

84657 Issued in WV

Practice address

107 E Main St
Grayson, KY 41143-1301

Phone

(606) 474-0244

Fax

(606) 474-0412

NPI assigned

Mar 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Stacy Brooke Menix-Layne Other name

Medicare fee-for-service enrollment

Enrolled in WV, KY2 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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Medical ClinicGroup PAC ID 0547616401, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

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 and National Provider Directory roles.

• Main Street Medical Clinic

  • Family Nurse Practitioner
  • Grayson, KY
  • NPI 1952180408
  Medicare reassignment Care Compare group NPD Authorized official
• Racine Observation Medical Group, PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1588196851
  Medicare reassignment NPD
• Allied West Virginia Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1487109104
  Medicare reassignment

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

• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1144647652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E MAIN ST",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431301",
            "telephone_number": "606-474-0244",
            "fax_number": "606-474-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E MAIN ST",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431301",
            "telephone_number": "606-474-0244",
            "fax_number": "606-474-0412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 First Avenue",
            "address_2": "Room 1025",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021241",
            "country_code": "US",
            "telephone_number": "304-399-7484",
            "fax_number": "304-399-7579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "STACY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "84657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102228",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3053133",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100295790",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MENIX-LAYNE",
            "middle_name": "BROOKE",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heritage Elem School Health Center
• Hidden Valley Healthcare PLLC
• Teresa Hilburn, RN
• Shelby Anne Hill, APRN
• Leonard David Hilley III
• Amy Holton
• Hometown Health PLLC
• Christopher Stephen Hord, PA-C
• Allison Horsley, PHARMD
• Horton Brothers and Brown LLC

• Family Nurse Practitioner in Grayson, KY
• Providers in Grayson, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.
• 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.