Individual provider Active NPI

Stacy Stats, CNS

  • Critical Care Medicine Clinical Nurse Specialist
  • Fort Belvoir, VA
National Provider Identifier
1386365542
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
License
4515 Issued in CA
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone
(760) 637-7813
NPI assigned
Sep 7, 2022
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Clinical Nurse Specialist 364SC0200X 4515 CA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Mailing address

15001 Pansy CT
Woodbridge, VA 22193-3385
Phone (760) 637-7813

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)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
4515CAMDCritical Care Medicine Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1386365542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 PANSY CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933385",
            "telephone_number": "760-637-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "760-637-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATS",
        "first_name": "STACY",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "CA",
            "license": "4515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.