Individual provider Active NPI

Stacey Obrien Eadie, NP

  • Nurse Practitioner
  • Glen Mills, PA
National Provider Identifier
1255471124
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP006103B Issued in PA
Practice address
100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone
(610) 387-4520
Fax
(610) 387-4526
NPI assigned
Feb 8, 2007
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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 SP006103B PA Primary

Addresses

Primary practice location

100 Maris Grove Way
Glen Mills, PA 19342-1282

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (610) 387-4520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20040819000611 PA Practitioner - Nurse Practitioner 0547233298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone (610) 387-4520

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Erickson Health Medical Group of Pennsylvania PC CurrentSince Apr 6, 2014 Accepting new patients
Erickson Health Medical Group of Pennsylvania, PC CurrentSince Apr 6, 2014 Accepting new patients
Health Access Network Past Accepting new patients

Locations

5730 Executive Dr
Ste 230
Catonsville, MD 21228
Phone (410) 402-2379

5525 Research Park Dr
Fl 4
Catonsville, MD 21228
Phone (410) 247-5602

100 Maris Grove Way
Glen Mills, PA 19342
Phone (610) 387-4520

10000 Anns Choice Way
Warminster, PA 18974
Phone (215) 443-3801

Organizations & group practices 3

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1255471124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "610-387-4520",
            "fax_number": "610-387-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIS GROVE WAY",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421282",
            "telephone_number": "610-387-4520",
            "fax_number": "610-387-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADIE",
        "first_name": "STACEY",
        "middle_name": "OBRIEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP006103B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

Verify at the official NPI Registry.