Brenda Stack, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP013188 Issued in PA

Practice address

1 Guthrie SQ
Sayre, PA 18840-1625

Phone

(570) 888-5858

NPI assigned

Nov 8, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NY2 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

Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Guthrie Home Health Home health agency, Towanda, PA, CCN 397120
• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079
• Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
• Corning Hospital Hospital, Corning, NY, CCN 330277

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bstack49261@direct-guthrie.org

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.

• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C,

  • Diagnostic Radiology Physician
  • Towanda, PA
  • NPI 1598892333
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Towanda, PA
  • NPI 1811946304
  NPD
• Community Health Associates

  • Nurse Practitioner
  • Towanda, PA
  • NPI 1245667120
  NPD (past)
• Guthrie Medical Group PC

  • Clinical Medical Laboratory
  • Sayre, PA
  • NPI 1649225855
  NPD (past)

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

• Guthrie Home Care

  • Home Health Agency
  • Towanda, PA
  • NPI 1265438733
  Care Compare affiliation Name & address match
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation
• Corning Hospital

  • General Acute Care Hospital
  • Corning, NY
  • NPI 1346241973
  Care Compare affiliation
• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Care Compare affiliation

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1164851259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "BRENDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP013188",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "PA",
            "license": "SP013188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP  LICENSE #",
            "identifier": "SP013188",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julana Michelle Spaulding, CNM
• Jeanenne Spencer
• Daniel Primes Sporn, MD
• Panit Hirunsri Srivatana, MD
• Ukorn Srivatana, MD
• Kara K Stage
• Sara Lynn Stamp, RD
• James Stanek, DO
• Dwight David Stapleton, MD
• Sarah Statts

• Nurse Practitioner in Sayre, PA
• Providers in Sayre, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.