Individual provider Active NPI

Stacy Katherine Tucker, CNM

  • Advanced Practice Midwife
  • Altamonte Springs, FL
National Provider Identifier
1255875472
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
11025853 Issued in FL
Practice address
661 E Altamonte Dr Ste 318
Altamonte Springs, FL 32701-5103
Phone
(407) 303-5204
NPI assigned
Dec 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X APRN11025853 FL
Advanced Practice Midwife 367A00000X 09000282A IN
Advanced Practice Midwife 367A00000X 4704338854 MI
Advanced Practice Midwife 367A00000X 11025853 FL Primary

Addresses

Primary practice location

661 E Altamonte Dr Ste 318
Altamonte Springs, FL 32701-5103

Mailing address

661 E Altamonte Dr Ste 318
Altamonte Springs, FL 32701-5103
Phone (407) 303-5204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721001577 FL Practitioner - Certified Nurse Midwife (CNM) 5698059624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 318
Altamonte Springs, FL 32701-5103
Phone (407) 303-5204

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN11025853FLMDObstetrics & Gynecology Physician
11025853FLMDAdvanced Practice Midwife
09000282AINMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Obstetrics & Gynecology CurrentSince Jul 17, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 17, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 318
Altamonte Springs, FL 32701
Phone (407) 303-5204

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: shendershott1596315@adventhealth.direct-ci.com
  • Direct secure messaging: shendershott259749@direct.promedica.org

Organizations & group practices 2

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 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": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1255875472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 E ALTAMONTE DR STE 318",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015103",
            "telephone_number": "407-303-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 E ALTAMONTE DR STE 318",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015103",
            "telephone_number": "407-303-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "STACY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN11025853",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000282A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704338854",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "11025853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.