Stephanie Perrett Eads, APRN, BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R854570 Issued in MS

Practice address

119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998

Phone

(423) 282-1480

Fax

(423) 928-5313

NPI assigned

Dec 11, 2006

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 identifiers 1

Other names 1

• Mrs. Stephanie Perrett Haley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1306906516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 NELIA RD",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389018066",
            "telephone_number": "662-609-2233",
            "fax_number": "662-226-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "SUITE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADS",
        "first_name": "STEPHANIE",
        "middle_name": "PERRETT",
        "name_prefix": "Mrs.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R854570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09356261",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HALEY",
            "middle_name": "PERRETT",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• E C Rider LLC
• E.W. Cooper D.D.S
• David Anderson Eades, PHARM.D.
• Emily Eads, CRNA
• Noelle M Eads, DPT
• Ear Nose and Throat Associates PC
• Ear Nose and Throat Associates, P.C.
• Megan Elizabeth Earls, MS, RD
• Earth Remedy Optimal Wellness LLC
• John Tyler Earwood, PA

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.