Stacy Ann Harris Hernandez, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024186270 Issued in VA

Practice address

2206 Executive Dr Ste F
Hampton, VA 23666-2583

Phone

(757) 825-1440

Fax

(757) 825-1587

NPI assigned

Apr 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy Ann Harris Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, VA2 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

University of Michigan Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Vienna, VA
  • NPI 1891169975
  Medicare reassignment Care Compare group NPD
• Canton Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Canton, MI
  • NPI 1649712480
  Medicare reassignment NPD
• Best Urgent Care PC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1952791105
  Medicare reassignment
• Ypsilanti Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Ypsilanti, MI
  • NPI 1881048494
  Medicare reassignment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1215434253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 EXECUTIVE DR STE F",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662583",
            "telephone_number": "757-825-1440",
            "fax_number": "757-825-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "STACY",
        "middle_name": "ANN HARRIS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024186270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Stacy.Harris@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2206 Executive Dr Ste F",
            "city": "Hampton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236662583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HARRIS",
            "middle_name": "ANN",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McKenzie O Henry, COTA/L
• Michael George Henry, LPN
• Heritage Behavioral Health LLC
• David W. Hermann
• Gretchen E Hernandez Lopez, PH.D.
• Sadie Herts, LPC
• Diana Helen Hess-Fisher, PT
• Angela K Hetrick, CNA
• Latascha Hiban, LPC
• Amanda Hickerson, LPC

• Family Nurse Practitioner in Hampton, VA
• Providers in Hampton, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.