Individual provider Active NPI

Melanie Vining Stacey, CRNP

  • Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1184134520
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F061712115 Issued in AL
Practice address
100 Pilot Medical Dr Ste 300
Birmingham, AL 35235-3412
Phone
(205) 815-4777
Fax
(205) 815-4777
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X F061712115 AL Primary

Addresses

Primary practice location

100 Pilot Medical Dr Ste 300
Birmingham, AL 35235-3412

Mailing address

100 Pilot Medical Dr Ste 300
Birmingham, AL 35235-3412
Phone (205) 856-2284

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220921003999 AL Practitioner - Nurse Practitioner 6002291317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southview Medical Group, PCGroup PAC ID 8729979794, 40 clinicians

Practice addresses (Care Compare)

833 Saint Vincents Dr
Suite 300
Birmingham, AL 35205-1612
Phone (205) 933-4640

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F061712115ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southview Medical Group, PC Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
Uab Southview LLC Past Accepting new patients

Locations

833 Saint Vincents Dr
Ste 500
Birmingham, AL 35205
Phone (205) 558-4067

833 Saint Vincents Dr
Ste 300
Birmingham, AL 35205
Phone (205) 933-4640

833 Saint Vincents Dr
Ste 502
Birmingham, AL 35205
Phone (205) 933-4400

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 and National Provider Directory roles.

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": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1184134520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DR STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353412",
            "telephone_number": "205-856-2284",
            "fax_number": "205-815-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DR STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353412",
            "telephone_number": "205-815-4777",
            "fax_number": "205-815-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "MELANIE",
        "middle_name": "VINING",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "F061712115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.