Individual provider Active NPI

Jamie Leeanne Stack, RN

  • Registered Nurse
  • Hillsboro, OH
National Provider Identifier
1144698366
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.354323 Issued in OH
Practice address
331 W Walnut St
Hillsboro, OH 45133-1335
Phone
(937) 205-4312
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.354323 OH Primary

Addresses

Primary practice location

331 W Walnut St
Hillsboro, OH 45133-1335

Mailing address

331 W Walnut St
Hillsboro, OH 45133-1335
Phone (937) 205-4312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.354323OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1144698366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W WALNUT ST",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "451331335",
            "telephone_number": "937-205-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W WALNUT ST",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "451331335",
            "telephone_number": "937-205-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "JAMIE",
        "middle_name": "LEEANNE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.354323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.