Stacy M Speck, RD, RN, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

.0032134 Issued in OH

Practice address

11100 Euclid Ave RM B501
Cleveland, OH 44106-1716

Phone

(216) 844-5741

Fax

(216) 844-5710

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sspeck27904@ehrdirect.uhhospitals.org

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.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment NPD
• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)
• Multicare Health System

  • Nurse Practitioner
  • Tacoma, WA
  • NPI 1407808413
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1366642860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 DETROIT AVE APT 618",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132448",
            "telephone_number": "419-564-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE RM B501",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-5741",
            "fax_number": "216-844-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECK",
        "first_name": "STACY",
        "middle_name": "M",
        "credential": "RD, RN, APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209006587",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": ".0032134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Elaine Specht, MD
• Specialty Hospital of Cleveland, Inc.
• Specialty Hospital of Cleveland, Inc.
• Brittney L Speck
• Phillip M Speck, QMHS
• Emily Spector, MS
• Spectrum Diagnostic Imaging of Ohio LLC
• Spectrum Diagnostic Imaging of Ohio LLC
• Spectrum Diagnostic Imaging of Ohio LLC
• Spectrum Home Health Care, LLC

• Pediatric Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.