Stacy Ellen Vermillion, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Williamsport, MD
NPI 1386477008 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1386477008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AC006956 (MD)
- Practice address
- 3 Byrkit Dr
Williamsport, MD 21795-1171 - Phone
- (301) 582-1150
- Fax
- (301) 582-0905
- NPI assigned
- Aug 20, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Meritus Medical Center Inc
Medical Practices of Antietam, LLC
Practice addresses (Care Compare)
11110 Medical Campus Rd
Hagerstown, MD 21742-6700
3 Byrkit Dr
Williamsport, MD 21795-1158
Phone (301) 582-1150
Hospital & facility affiliations
- Home Call
- Meritus Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241226002208 | MD | Practitioner - Nurse Practitioner | 0042747388 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R243153 | MD | MD | Registered Nurse |
| AC006956 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Practices of Antietam LLC | Current |
Accepting new patients | |
| Medical Practices of Antietam, LLC | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AC006956 | MD | Yes |
| Registered Nurse | 163W00000X | R243153 | MD |
Addresses
Primary practice location
3 Byrkit Dr
Williamsport, MD 21795-1171
Mailing address
138 Achilla Ter
Martinsburg, WV 25404-3464
Phone (240) 344-2828
Other providers in Williamsport, MD
- Stay Home Senior Services of Maryland, Inc.
- Danielle Nicole Taylor
- Viet T Tran
- Lisa Trevan
- Twin Oaks Operator LLC
- Danielle Walters
- Cheree Ware
- Washington County Health Department
- Makeisha Washington
- Hannah Williams
All providers in Williamsport, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.