Sandra Jo Stack, APRN-FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

104460 Issued in WV

Practice address

250 Stanaford Rd
Beckley, WV 25801-3140

Phone

(304) 255-2668

NPI assigned

Sep 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Appalachian Regional Healthcare IncGroup PAC ID 0840107835, 301 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beckley Arh Home Health Home health agency, Beckley, WV, CCN 517076
• Beckley Arh Hospital Hospital, Beckley, WV, CCN 510062
• Camc Greenbrier Valley Medical Center, Inc Hospital, Ronceverte, WV, CCN 510002
• Raleigh General Hospital Hospital, Beckley, WV, CCN 510070

Merit-based Incentive Payment System (MIPS)

Final score

82.15 of 100Reported as apm

Quality

47.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandrastack@arh.medalliesdirect.net
• Direct secure messaging: sandra.stack.1@6482.direct.athenahealth.com

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.

• Appalachian Regional Healthcare, Inc

  • Family Medicine Physician
  • Beckley, WV
  • NPI 1477510162
  Medicare reassignment Care Compare group NPD
• Appalachian Regional Healthcare, Inc

  • Community/Retail Pharmacy
  • Cumberland, KY
  • NPI 1710870811
  NPD
• Greenbrier Care LLC

  • Family Medicine Physician
  • White Sulphur Springs, WV
  • NPI 1629266432
  NPD (past)

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

• Appalachian Regional Healthcare Inc

  • Home Health Agency
  • Beckley, WV
  • NPI 1780679332
  Care Compare affiliation
• Appalachian Regional Healthcare, Inc

  • Family Medicine Physician
  • Beckley, WV
  • NPI 1477510162

  Hospital

  Care Compare affiliation
• Appalachian Regional Healthcare, Inc

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1568461440
  Care Compare affiliation
• Camc Greenbrier Valley Medical Center Inc

  • General Acute Care Hospital
  • Ronceverte, WV
  • NPI 1679299408
  Care Compare affiliation
• Raleigh General Hospital LLC

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1629015698
  Care Compare affiliation

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1235788845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 STANAFORD RD STE 106",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013140",
            "telephone_number": "304-255-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 STANAFORD RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013140",
            "telephone_number": "304-255-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "SANDRA",
        "middle_name": "JO",
        "credential": "APRN-FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Spencer
• Jenny Sprouse
• Lamar Spuriell
• Staci Dawn Spurlock, COTA/L
• Allison Brook St.Clair
• Clint Jay Stacy, PRSS-SUD
• Samantha L Stacy
• Bradley Mason Stafford, FNP-C
• Bryan S Stafford, PA C
• Carol June Stafford

• Family Nurse Practitioner in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.