Individual provider Active NPI

Stephanie Nichole Chestnut, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1164101242
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1128712 Issued in TX
Practice address
1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone
(806) 212-2000
NPI assigned
Jul 14, 2023
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1128712 TX Primary

Addresses

Primary practice location

1600 Wallace Blvd
Amarillo, TX 79106-1799

Mailing address

6 Medical Dr
Amarillo, TX 79106-4136
Phone (806) 212-6604

Other practice location 1

6 Medical Dr
Amarillo, TX 79106-4136
Phone (806) 212-6604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20230913001724 TX Practitioner - Nurse Practitioner 8224492962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1000 S Coulter St
Suite 100
Amarillo, TX 79106-1781
Phone (806) 212-4701

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

1751 Wallace Blvd
Amarillo, TX 79106-1711
Phone (806) 359-4673

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1128712TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince Sep 1, 2023 Accepting new patients
Bsa Physicians Group Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

1000 S Coulter St
Ste 200
Amarillo, TX 79106
Phone (806) 212-4535

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

6 Medical Dr
Amarillo, TX 79106
Phone (806) 212-6604

Interoperability endpoints

  • Direct secure messaging: schestnut22569@ahs.direct-ci.com

Organizations & group practices 2

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 1

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": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1164101242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MEDICAL DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064136",
            "telephone_number": "806-212-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-212-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791064136",
            "country_code": "US",
            "telephone_number": "806-212-6604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHESTNUT",
        "first_name": "STEPHANIE",
        "middle_name": "NICHOLE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1128712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.