Stacey Nicole Gibson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R170910 Issued in MD

Practice address

11110 Medical Campus Rd Ste 147
Hagerstown, MD 21742-6755

Phone

(301) 714-4350

NPI assigned

Aug 16, 2016

Last updated

Aug 19, 2021By 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 1

Addresses

Other names 1

• Mrs. Stacey Nicole Talbert Former name

Medicare fee-for-service enrollment

Enrolled in WV

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 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospice of the Panhandle, Inc.Group PAC ID 2466558937, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Panhandle Home Health, Inc. Home health agency, Martinsburg, WV, CCN 517035

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Hospice of the Panhandle, Inc.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Kearneysville, WV
  • NPI 1740865179
  Medicare reassignment Care Compare group NPD
• Matrix Medical Network of West

  dba Matrix Medical Network

  • Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1942569033

  WV

  Medicare reassignment NPD
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  WV

  Medicare reassignment NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Hospice of the Panhandle, Inc.

  • Community Based Hospice Care Agency
  • Kearneysville, WV
  • NPI 1124025697
  NPD (past)

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

• Panhandle Home Health Inc

  • Home Health Agency
  • Martinsburg, WV
  • NPI 1174588750
  Care Compare affiliation

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1154876423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 147",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 147",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11116 Medical Campus Rd",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426710",
            "country_code": "US",
            "telephone_number": "301-988-7822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "STACEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R170910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "TALBERT",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suhair Ghanim, LCSWC
• Hridaya Bibhu Ghimire
• Lauren Gibble, LCPC
• Charles Larry Gibbs Jr., DACM, L.AC.
• Joseph Gibney, M.D.
• Victoria Marie Saah Giffi, MD
• William David Gift, DC, DABFP, DABCC
• Jonathan Craig Gilbart, DDS
• Gilbert Weaver and Associates (Brunswick Physical Therapy)
• Teresa S Gilbert, LCSW-C

• Family Nurse Practitioner in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.