Individual provider Active NPI

Stacey Pappas, APRN

  • Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1205250560
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9226836 Issued in FL
Practice address
2300 Loveland Blvd Unit 2
Port Charlotte, FL 33980-5716
Phone
(941) 307-3124
Fax
(844) 339-5286
NPI assigned
Feb 6, 2014
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9226836 FL Primary

Addresses

Primary practice location

2300 Loveland Blvd Unit 2
Port Charlotte, FL 33980-5716

Mailing address

2300 Loveland Blvd Unit 2
Port Charlotte, FL 33980-5716
Phone (941) 307-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 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
I20140501001875 FL Practitioner - Nurse Practitioner 9234362054 Reassigns benefits to 2 organizations
I20181226001426 TN Practitioner - Nurse Practitioner 9234362054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2350
Phone (561) 391-3333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9226836FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC Nurse Practitioner CurrentSince May 21, 2019 Accepting new patients
ENT and Allergy Associates of Florida, LLC CurrentSince Apr 1, 2026 Accepting new patients
ENT Associates PA CurrentSince Sep 23, 2022 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince May 21, 2019 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

2300 Loveland Blvd
Unit 1
Pt Charlotte, FL 33980
Phone (941) 743-6866

3390 Tamiami Trl
Ste 201
Pt Charlotte, FL 33952
Phone (816) 507-2741

2300 Loveland Blvd
Unit 2
Punta Gorda, FL 33980
Phone (941) 307-3124

5801 Crossings Blvd
Antioch, TN 37013
Phone (615) 885-0909

1642 Westgate Cir
Ste 202
Brentwood, TN 37027
Phone (615) 838-3845

851 S Willow Ave
Ste 112
Cookeville, TN 38501
Phone (615) 941-8538

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

3443 Dickerson Pike
Ste 590
Nashville, TN 37207
Phone (615) 637-7463

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: stacey.pappas.1@2765.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1205250560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LOVELAND BLVD UNIT 2",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339805716",
            "telephone_number": "941-307-3124",
            "fax_number": "844-339-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LOVELAND BLVD UNIT 2",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339805716",
            "telephone_number": "941-307-3124",
            "fax_number": "844-339-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "STACEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9226836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.