NPIMap

Individual provider Active NPI

Stacy Newbern, APRN

  • Family Nurse Practitioner
  • Soldotna, AK
National Provider Identifier
1386020352
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30070 Issued in TN
Practice address
245 N Binkley St Ste 101
Soldotna, AK 99669-7500
Phone
(907) 714-4111
Fax
(615) 904-6022
NPI assigned
Jul 31, 2015
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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 30070 TN Primary

Addresses

Primary practice location

245 N Binkley St Ste 101
Soldotna, AK 99669-7500

Mailing address

250 Hospital PL
Soldotna, AK 99669-6999
Phone (406) 301-3941

Other names 1

  • Stacy Johnston Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SNEWBERN626761@AK.PROVIDENCEDIRECT.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190320000292 AK Practitioner - Nurse Practitioner 9436499910 Reassigns benefits to 1 organization
I20200107000547 TX Practitioner - Nurse Practitioner 9436499910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

245 N Binkley St
Soldotna, AK 99669-7500
Phone (907) 714-4521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30070TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Medical Imaging PLLC Current Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
Central Peninsula General Hospital Inc. Current Accepting new patients
Newbern Family Healthcare, LLC Current Accepting new patients
Central Peninsula General Hospital Inc CurrentSince Aug 1, 2024 Accepting new patients
Carespot of Murfreesboro (1340 Broad Street), LLC PastSince Oct 1, 2022 Accepting new patients

Locations

245 N Binkley St
Soldotna, AK 99669
Phone (907) 714-4521

245 N Binkley St
Ste 101
Soldotna, AK 99669
Phone (907) 714-4111

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Interoperability endpoints

  • Direct secure messaging: snewbern626761@ak.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1386020352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996696999",
            "telephone_number": "406-301-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST STE 101",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697500",
            "telephone_number": "907-714-4111",
            "fax_number": "615-904-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERN",
        "first_name": "STACY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SNEWBERN626761@AK.PROVIDENCEDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "245 N Binkley St Ste 101",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "JOHNSTON",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.