Active NPI
Stacia Shryock
- Family Nurse Practitioner
- Hilo, HI
National Provider Identifier
1386222776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3014932
- Practice address
- 1190 Waianuenue Ave
Hilo, HI 96720-2089 - Phone
- (808) 932-3428
- NPI assigned
- Mar 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3014932 | KY | Primary |
Addresses
Primary practice location
1190 Waianuenue Ave
Hilo, HI 96720-2089
Mailing address
601 Wickfield Dr
Louisville, KY 40245-4092
Phone (410) 336-1381
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sshryock@hhsc.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3014932 | KY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1386222776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 WICKFIELD DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402454092",
"telephone_number": "410-336-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 WAIANUENUE AVE",
"city": "HILO",
"state": "HI",
"postal_code": "967202089",
"telephone_number": "808-932-3428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRYOCK",
"first_name": "STACIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3014932",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sshryock@hhsc.org",
"affiliation": "N",
"address_1": "1190 Waianuenue Ave",
"city": "Hilo",
"state": "HI",
"country_code": "US",
"postal_code": "967202089",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.