Individual provider Active NPI

Stacy Ann Thalassites, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1376650457
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN1709122 Issued in FL
Practice address
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone
(904) 202-3860
Fax
(904) 202-3846
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN1709122 FL
Nurse Practitioner 363L00000X APRN1709122 FL Primary
Acute Care Nurse Practitioner 363LA2100X ARNP1709122 FL

Addresses

Primary practice location

820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041214000863 FL Practitioner - Nurse Practitioner 0749247435 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

110 Health Park Blvd
Saint Augustine, FL 32086-5776
Phone (904) 823-3401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1709122FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villages Regional Hospital Physician Services LLC CurrentSince Jun 10, 2025 Accepting new patients
Symphony Specialty Group, LLC CurrentSince Oct 2, 2025 Accepting new patients
South Broward Hospital District CurrentSince Jun 16, 2022 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Feb 6, 2024 Accepting new patients
Flagler Professional Health Care Services, Inc. Nurse Practitioner CurrentSince Mar 17, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Mar 17, 2025 Accepting new patients
South Broward Hospital District CurrentSince Jun 16, 2022 Accepting new patients
Jacksonville Hospitalists PA CurrentSince Oct 2, 2025 Accepting new patients
Holy Cross Hospital Inc CurrentSince Feb 6, 2024 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Mar 17, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. Past Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

1150 N 35th Ave
Ste 390
Hollywood, FL 33021
Phone (954) 265-7450

8613 Old Kings Rd S
Ste 602
Jacksonville, FL 32217
Phone (904) 493-3390

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

110 Health Park Blvd
St Augustine, FL 32086
Phone (904) 823-3401

100 Whetstone Pl
Ste 105
St Augustine, FL 32086
Phone (904) 824-3777

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: urgentcare@flaglerhealth.directbygreenway.com
  • Direct secure messaging: sthalassites754885@direct.shands.ufl.edu
  • Direct secure messaging: sthalassites304699@mhsdirect.net

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1376650457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALASSITES",
        "first_name": "STACY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN1709122",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN1709122",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP1709122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.