Individual provider Active NPI

Stacye Jeter, APN

  • Certified Registered Nurse Anesthetist
  • Paris, TN
National Provider Identifier
1205050770
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0000012607 Issued in TN
Practice address
301 Tyson Ave
Paris, TN 38242-4544
Phone
(731) 644-1220
NPI assigned
Apr 13, 2007
Last updated
May 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0000012607 TN Primary

Addresses

Primary practice location

301 Tyson Ave
Paris, TN 38242-4544

Mailing address

301 Tyson Avenue
Paris, TN 38242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000614 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305019035 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians

Practice addresses (Care Compare)

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

80 Humphreys Ctr Dr
Suite 310
Memphis, TN 38120-2361
Phone (901) 747-3370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0000012607TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry County Medical Center Current Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
West Tennessee Healthcare Henry County Nurse Anesthetist, Certified Registered CurrentSince May 15, 2016 Accepting new patients
Henry County Medical Center CurrentSince May 15, 2016 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Oct 1, 2020 Accepting new patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Northstar Anesthesia of Tennessee, PLLC CurrentSince Jan 1, 2012 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

80 Humphreys Center Dr
Ste 310
Memphis, TN 38120
Phone (901) 474-3370

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

1015 Kelley Dr
Ste 200
Paris, TN 38242
Phone (731) 644-2271

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/b673e6c7-c87b-498f-86b2-99b24c52c924/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1205050770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TYSON AVENUE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "38242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TYSON AVE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424544",
            "telephone_number": "731-644-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "STACYE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "0000012607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.