Individual provider Active NPI

Alicia D Stidam, APRN, FNP-BC

  • Family Nurse Practitioner
  • Morehead, KY
National Provider Identifier
1285231258
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015232 Issued in KY
Practice address
245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone
(606) 780-5500
Fax
(606) 783-7281
NPI assigned
Oct 2, 2020
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3015232 KY
Family Nurse Practitioner 363LF0000X 3015232 KY Primary

Addresses

Primary practice location

245 Flemingsburg Rd
Morehead, KY 40351-1015

Mailing address

41 Homeplace Way
Morehead, KY 40351-9071
Phone (606) 784-5894

Other practice location 1

41 Homeplace Way
Morehead, KY 40351-9071
Phone (606) 784-5894

Other identifiers 1

IdentifierTypeStateIssuer
3015232OtherKYKY MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210407002492 KY Practitioner - Nurse Practitioner 5496162539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Claire Medical Center IncGroup PAC ID 4486559085, 181 clinicians

Practice addresses (Care Compare)

245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone (606) 780-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Claire Medical Center Inc. CurrentSince Apr 1, 2021 Accepting new patients
St. Claire Medical Center, Inc Current Accepting new patients
St. Claire Medical Center, Inc Current Accepting new patients
St Claire Medical Center, Inc Current Accepting new patients
St. Claire Medical Center, Inc Nurse Practitioner Current Accepting new patients
St. Claire Medical Center,Inc Current Accepting new patients
St Claire Medical Center, Inc CurrentSince Apr 1, 2021 Accepting new patients
St. Claire Medical Center, Inc Nurse Practitioner Current Accepting new patients
St. Claire Medical Center,Inc Current Accepting new patients
St Claire Regional Radiology Physicians Services Current Accepting new patients
Black & Carpenter PSC Current Accepting new patients
St Claire Medical Center, Inc., Family Current Accepting new patients
St Claire Medical Center, Inc., Nurse Practitioner PastSince Aug 27, 2023 Accepting new patients
Sprocket Medical Management LLC Past Accepting new patients

Locations

732 Highway 36
Frenchburg, KY 40322
Phone (606) 768-2191

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

234 Medical Cir
Morehead, KY 40351
Phone (606) 784-6641

234 Medical Cir
Ste 1
Morehead, KY 40351
Phone (606) 784-6641

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

255 Old Viking Dr
Morehead, KY 40351
Phone (606) 784-2774

316 W 2nd St
Morehead, KY 40351
Phone (606) 783-6400

555 W Sun St
Morehead, KY 40351
Phone (606) 207-2931

632 Slate Ave
Owingsville, KY 40360
Phone (606) 674-6386

390 S Ky 7
Sandy Hook, KY 41171
Phone (606) 738-5155

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1285231258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 HOMEPLACE WAY",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403519071",
            "telephone_number": "606-784-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511015",
            "telephone_number": "606-780-5500",
            "fax_number": "606-783-7281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Homeplace Way",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403519071",
            "country_code": "US",
            "telephone_number": "606-784-5894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIDAM",
        "first_name": "ALICIA",
        "middle_name": "D",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3015232",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAL LICENSE",
            "identifier": "3015232",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.