Stacy E Reichert, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN118735 Issued in GA

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(800) 328-5979

NPI assigned

Nov 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy E Holt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sylvester Pediatrics & Adolescent Medicine, P.C.

  • Pediatrics Physician
  • Sylvester, GA
  • NPI 1629125505
  NPD (past)

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600560000000",
    "number": "1285934703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 KENNEDY RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944155",
            "telephone_number": "229-726-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "800-328-5979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 W Kelly St",
            "address_purpose": "LOCATION",
            "city": "Sylvester",
            "state": "GA",
            "postal_code": "317912021",
            "country_code": "US",
            "telephone_number": "229-777-0488",
            "fax_number": "229-777-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHERT",
        "first_name": "STACY",
        "middle_name": "E",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2020-09-20",
        "certification_date": "2020-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN118735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HOLT",
            "middle_name": "E",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reemo Health, Inc
• Angela Reese, NP
• Shannon Regan, BCBA
• Regional Anesthesia Services PA
• Brandon Jacob Rehnelt, LMFT
• Dianne L Reid, OTR / L
• Kenna Elizabeth Reid
• Rachel Marie Reifenberger, LICSW
• Renae Mary Reinardy Kragness, PSY.D., LP
• Livia Marie Reinarts, BA

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.