Stacey Reynolds Dahl, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

163327 Issued in AK

Practice address

103 Fram Treet
Petersburg, AK 99833-0589

Phone

(907) 772-4291

Fax

(907) 773-3085

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: sdahl20022@carelonhealth.direct-ci.com

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.

• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  OR

  Medicare reassignment

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1396342895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1732",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998331732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FRAM TREET",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330589",
            "telephone_number": "907-772-4291",
            "fax_number": "907-773-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "STACEY",
        "middle_name": "REYNOLDS",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "163327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Anita Banda, LCSW
• Philip Gaither Beardslee, DMD
• Brandy Boggs
• Yvette C Boggs, R.N.
• Selina Andrea Burt, D.O.
• Tiffany Eckles
• Adriene Kim Fedde, MD
• Margaret D Fleming, MS,RD,LD
• Peggy Ann Floro, BA
• Amanda Galaktionoff, PT, DPT

• Family Nurse Practitioner in Petersburg, AK
• Providers in Petersburg, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.