Individual provider Active NPI

Stacie Nelson, NP

  • Acute Care Nurse Practitioner
  • Temple, TX
National Provider Identifier
1164518502
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1177888 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
Fax
(254) 724-7603
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1177888 TX Primary
Adult Health Nurse Practitioner 363LA2200X 17242 TN
Adult Health Nurse Practitioner 363LA2200X RN129463NP GA

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

PO Box 844658
Suite B
Dallas, TX 75284-4658
Phone (800) 994-0371

Other practice location 1

144 Medical Center Dr
Suite B
Copperhill, TN 37317-5005
Phone (423) 496-9214

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address snelson1446859@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 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
I20130409000161 TN Practitioner - Nurse Practitioner 4880694389 Reassigns benefits to 2 organizations
I20250717000534 TX Practitioner - Nurse Practitioner 4880694389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17242TNMDPediatric Hematology & Oncology Physician
1177888TXMDAcute Care Nurse Practitioner
RN129463NPGAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Centers of East Tennessee, P.C. CurrentSince Jun 1, 2017 Accepting new patients
Mahmood a Siddiqui MD PC CurrentSince Mar 1, 2013 Accepting new patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Aug 1, 2025 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

4021 Keith St NW
Cleveland, TN 37312
Phone (423) 476-2464

144 Medical Center Dr
Ste B
Copperhill, TN 37317
Phone (423) 496-9214

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1164518502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "address_2": "SUITE B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111",
            "fax_number": "254-724-7603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Medical Center Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Copperhill",
            "state": "TN",
            "postal_code": "373175005",
            "country_code": "US",
            "telephone_number": "423-496-9214",
            "fax_number": "423-496-7809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "STACIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1177888",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "17242",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN129463NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snelson1446859@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.