Individual provider Active NPI

Stacey Lynn Crane, NP-C

  • Family Nurse Practitioner
  • Houghton Lake, MI
National Provider Identifier
1366979338
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704254946 Issued in MI
Practice address
9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone
(989) 422-2181
NPI assigned
May 22, 2017
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704254946 MI Primary

Addresses

Primary practice location

9249 W Lake City Rd
Houghton Lake, MI 48629-9602

Mailing address

9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone (989) 422-2181

Other practice location 1

3009 N Saginaw Rd
Midland, MI 48640-4555
Phone (989) 633-1350

Other names 1

  • Stacey Wysocki Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swysocki@direct.mhc.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170804000991 MI Practitioner - Nurse Practitioner 6608147996 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northsport Physical Therapy and Rehabilitation P CGroup PAC ID 5294902508, shared by 2 NPIs, 43 clinicians
Midmichigan Health ServicesGroup PAC ID 7911800495, 27 clinicians

Practice addresses (Care Compare)

1622 Dickerson Rd
Gaylord, MI 49735-9206

9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone (989) 422-5122

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Aug 7, 2017 Accepting new patients
Epmg of Michigan, P.C. Nurse Practitioner CurrentSince Jul 4, 2017 Accepting new patients
Munson Healthcare Grayling CurrentSince Aug 7, 2017 Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
Midmichigan Health Services Past Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

1321 S Mount Tom Rd
Mio, MI 48647
Phone (989) 275-1200

234 Lake St
Roscommon, MI 48653
Phone (517) 275-1200

Interoperability endpoints

  • Direct secure messaging: scranenpprovider82701@mymichiganhealth.midirect.net
  • Direct secure messaging: swysocki@direct.mhc.net

Organizations & group practices 13

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 13

Hospital & facility affiliations 4

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1366979338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9249 W LAKE CITY RD",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299602",
            "telephone_number": "989-422-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9249 W LAKE CITY RD",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299602",
            "telephone_number": "989-422-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3009 N Saginaw Rd",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486404555",
            "country_code": "US",
            "telephone_number": "989-633-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANE",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704254946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swysocki@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1250 E Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497387074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "WYSOCKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houghton Lake, MI

Sources for this page

Verify at the official NPI Registry.