Individual provider Active NPI

Stacy Marie Gutierrez, FNP-C

  • Family Nurse Practitioner
  • Magnolia, TX
National Provider Identifier
1366856536
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142069 Issued in TX
Practice address
20003 Mahogany Ridge Dr
Magnolia, TX 77355-4996
Phone
(443) 955-9836
NPI assigned
Jun 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 898509 TX
Registered Nurse 163W00000X 754202 TX
Lactation Consultant (Registered Nurse) 163WL0100X 202997 TX
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP142069 TX Primary

Addresses

Primary practice location

20003 Mahogany Ridge Dr
Magnolia, TX 77355-4996

Mailing address

20003 Mahogany Ridge Dr
Magnolia, TX 77355-4996
Phone (443) 955-9836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210610002267 TX Practitioner - Nurse Practitioner 4789084864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians

Practice addresses (Care Compare)

16605 Southwest Fwy
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 Southwest Fwy 400 Mob3
Methodist Family Medicine Group
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 SW Fwy 410
Methodist Diag Card of Houston
Sugar Land, TX 77479-3500
Phone (281) 274-0148

4710 Bellaire Blvd
Bellaire, TX 77401-4505
Phone (713) 363-9411

7575 San Felipe St
Suite 155
Houston, TX 77063-1777
Phone (713) 266-9955

8520 Broadway St
Suite 100
Pearland, TX 77584-7716
Phone (713) 363-8016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
898509TXMDRegistered Dietitian
754202TXMDRegistered Nurse
202997TXMDLactation Consultant (Registered Nurse)
AP142069TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Oct 15, 2022 Accepting new patients
TMH Physician Associates PLLC Single Specialty CurrentSince Oct 15, 2022 Accepting new patients

Locations

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: stacy.gutierrez.1@21948.direct.athenahealth.com
  • Direct secure messaging: sgutierrez420847@directhoustonmethodist.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1366856536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20003 MAHOGANY RIDGE DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773554996",
            "telephone_number": "443-955-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20003 MAHOGANY RIDGE DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773554996",
            "telephone_number": "443-955-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "898509",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "754202",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "202997",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

Verify at the official NPI Registry.