Stacey Farrell, CNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11016785 Issued in FL

Practice address

4477 Legendary Dr Ste 201
Destin, FL 32541-5332

Phone

(850) 736-1251

NPI assigned

Jul 25, 2013

Last updated

May 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, FL2 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

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gulf Coast Pain Consultants LLCGroup PAC ID 1658516570, 37 clinicians

SNF Physiatry Services FL PLLCGroup PAC ID 7012436769, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

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

• SNF Physiatry Services FL PLLC

  • Physical Medicine & Rehabilitation Physician
  • Cross City, FL
  • NPI 1467255877
  Medicare reassignment Care Compare group NPD
• Gulf Coast Pain Consultants LLC

  dba Clearway Pain Solutions Institute

  • Interventional Pain Medicine Physician
  • Pensacola, FL
  • NPI 1669712287
  Medicare reassignment Care Compare group
• Skelly Medical Group LLC

  • Family Medicine Physician
  • Navarre, FL
  • NPI 1255018834
  Medicare reassignment NPD
• Bolivar Physician Practices LLC

  dba Bolivar Orthopedics

  • Orthopaedic Surgery Physician
  • Cleveland, MS
  • NPI 1063659530
  Medicare reassignment NPD
• Delta Medical Group

  • Emergency Medicine Physician
  • Greenville, MS
  • NPI 1790701134

  Family Medicine

  Medicare reassignment NPD
• Doctor United Group Inc

  dba Doctors United Group Inc

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1124581632
  NPD
• Bolivar Physician Practices LLC

  dba Rosedale Family Medical

  • Rural Health Clinic/Center
  • Rosedale, MS
  • NPI 1205489689
  NPD
• Delta Physician Practices

  • Family Nurse Practitioner
  • Greenville, MS
  • NPI 1598086639
  NPD (past)
• Northern Mississippi Vascular Access Center

  • Vascular & Interventional Radiology Physician
  • Greenville, MS
  • NPI 1821861378
  NPD (past)
• Trustcare Primary Care, LLC

  dba TrustCare Health, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1154763514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FULTON ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304314",
            "telephone_number": "662-455-4434",
            "fax_number": "662-455-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 LEGENDARY DR STE 201",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415332",
            "telephone_number": "850-736-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "STACEY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855653",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11016785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George England
• Lawrence Scott Ennis, MD
• Express Pensacola HHA, Inc. (Champion Home Health Care)
• Eyemart Express LLC
• Family First Vision Care PLLC (Pearle Vision)
• Benjamin Corey Fernandez, C-AA, DPT
• Haley Marie Fine
• Mara Jose Fiorentino, MD
• Angela M. Fiorita-Day, PSYD
• FL-I Medical Services LLC

• Family Medicine Physician in Destin, FL
• Providers in Destin, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2025; 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.