Stacy Graham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004680 Issued in AR

Practice address

17 Saint Thomas Dr
Maumelle, AR 72113-7003

Phone

(501) 912-2362

NPI assigned

Feb 22, 2016

Last updated

Feb 22, 2016By the provider in NPPES

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 AR

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benny J Green MD PAGroup PAC ID 8628021508, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgraham150774@direct.baptist-healthar.org

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.

• Benny J Green MD PA

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1043246168
  Medicare reassignment Care Compare group NPD

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

• Baptist Health

  dba Baptist Health Medical Center-Little Rock

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1245699024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SAINT THOMAS DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137003",
            "telephone_number": "501-912-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SAINT THOMAS DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137003",
            "telephone_number": "501-912-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Christine Gee, MS, OTR/L
• Morgan Elizabeth Gilley, PHARMD
• Tiffany Colleen Glass
• Anima Gnawali, DO
• Goals Ces Services, Inc
• Gwendolyn's Home Care Inc.
• Haas Psychiatric Services, P.a.
• Haas Psychiatric Services, PA
• David Charles Haas, M.D.
• Madison Hailey I, DR

• Family Nurse Practitioner in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.