NPIMap

Individual provider Active NPI

Lynn Anne Stackhouse-Roby, APRN, DNP

  • Adult Health Nurse Practitioner
  • Sandusky, OH
National Provider Identifier
1154542660
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.09403-NP Issued in OH
Practice address
1111 Hayes Ave
Sandusky, OH 44870-3323
Phone
(419) 557-7400
NPI assigned
May 1, 2007
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.09403-NP OH Primary

Addresses

Primary practice location

1111 Hayes Ave
Sandusky, OH 44870-3323

Mailing address

9323 Saybrook Dr
North Ridgeville, OH 44039-8748
Phone (440) 667-4511

Other names 1

  • Ms. Lynn Anne Stackhouse Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140522001524 OH Practitioner - Nurse Practitioner 7810051885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Hospitalist LLCGroup PAC ID 5496648123, 50 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

3700 Kolbe Rd
Lorain, OH 44053-1611
Phone (440) 960-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.09403-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Jul 1, 2018 Accepting new patients
Community Hospitalist, LLC CurrentSince Oct 15, 2015 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients
North Coast Professional Company, LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

11100 Euclid Ave
Cleveland Heights, OH 44106

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1154542660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9323 SAYBROOK DR",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440398748",
            "telephone_number": "440-667-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKHOUSE-ROBY",
        "first_name": "LYNN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.09403-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "STACKHOUSE",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.