Individual provider Active NPI

Michaela Smith-Stocker, DNP

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1255058863
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1099303 Issued in TX
Practice address
2901 Montopolis Dr
Austin, TX 78741-6411
Phone
(512) 978-9901
Fax
(512) 901-9746
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10044066 OR
Family Nurse Practitioner 363LF0000X 1099303 TX Primary

Addresses

Primary practice location

2901 Montopolis Dr
Austin, TX 78741-6411

Mailing address

2901 Montopolis Dr
Austin, TX 78741-6411
Phone (512) 978-9901

Other practice location 1

1226 Virginia Ave
North Bend, OR 97459-2716
Phone (541) 640-7625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 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
I20250811001546 OR Practitioner - Nurse Practitioner 2567960487 Reassigns benefits to 1 organization
I20251209001801 TX Practitioner - Nurse Practitioner 2567960487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1131 E International Airport Rd
Anchorage, AK 99518-1408
Phone (907) 276-2700

1226 Virginia Ave
North Bend, OR 97459-2716
Phone (541) 640-7625

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099303TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aleutian Pribilof Islands Association Inc CurrentSince Sep 27, 2025 Accepting new patients
Aleutian Pribilof Islands Assoc Inc CurrentSince Sep 27, 2025 Accepting new patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Jun 18, 2025 Accepting new patients
Icco, LLC Family Medicine Past Accepting new patients

Locations

1131 E Intl Airport Rd
Anchorage, AK 99518
Phone (907) 276-2700

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

108 NW Sisemore St
Ste 120
Bend, OR 97703
Phone (541) 213-2133

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

1226 Virginia Ave
North Bend, OR 97459
Phone (541) 305-4224

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1255058863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 MONTOPOLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787416411",
            "telephone_number": "512-978-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 MONTOPOLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787416411",
            "telephone_number": "512-978-9901",
            "fax_number": "512-901-9746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1226 Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "North Bend",
            "state": "OR",
            "postal_code": "974592716",
            "country_code": "US",
            "telephone_number": "541-640-7625",
            "fax_number": "541-644-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH-STOCKER",
        "first_name": "MICHAELA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10044066",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1099303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.