Individual provider Active NPI

Rachel L Stuck, FNP

  • Nurse Practitioner
  • Crittenden, KY
National Provider Identifier
1154087781
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3016985 Issued in KY
Practice address
405 Violet Rd
Crittenden, KY 41030-8956
Phone
(859) 428-1610
Fax
(859) 428-3923
NPI assigned
Nov 9, 2021
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0030197 OH
Nurse Practitioner 363L00000X 3016985 KY Primary

Addresses

Primary practice location

405 Violet Rd
Crittenden, KY 41030-8956

Mailing address

405 Violet Rd
Crittenden, KY 41030-8956
Phone (859) 428-1610

Other practice location 1

5505 Harrison Ave
Cincinnati, OH 45248-2311
Phone (513) 832-0980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 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
I20211216002787 KY Practitioner - Nurse Practitioner 3779974290 Reassigns benefits to 2 organizations
I20211216002846 OH Practitioner - Nurse Practitioner 3779974290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

405 Violet Rd
Crittenden, KY 41030-8956
Phone (859) 428-1610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0030197OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince May 15, 2023 Accepting new patients
Tristate Banp, LLC Nurse Practitioner CurrentSince Jan 6, 2026 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner Current Accepting new patients
Summit Medical Group, Inc. Nurse Practitioner CurrentSince May 15, 2023 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

100 Blackburn Ln
Dry Ridge, KY 41035
Phone (859) 823-5441

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: rstuck397701@direct-prd.stelizabeth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1154087781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 VIOLET RD",
            "city": "CRITTENDEN",
            "state": "KY",
            "postal_code": "410308956",
            "telephone_number": "859-428-1610",
            "fax_number": "859-428-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 VIOLET RD",
            "city": "CRITTENDEN",
            "state": "KY",
            "postal_code": "410308956",
            "telephone_number": "859-428-1610",
            "fax_number": "859-428-3923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5505 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452482311",
            "country_code": "US",
            "telephone_number": "513-832-0980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCK",
        "first_name": "RACHEL",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0030197",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3016985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crittenden, KY

Sources for this page

Verify at the official NPI Registry.