Individual provider Active NPI

Stacie Burleson, FNP

  • Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1407522758
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5014853 Issued in NC
Practice address
810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone
(828) 326-3000
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5014853 NC Primary

Addresses

Primary practice location

810 Fairgrove Church Rd
Hickory, NC 28602-9617

Mailing address

PO Box 822
Glen Alpine, NC 28628-0822
Phone (828) 443-9821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20211018002485 NC Practitioner - Nurse Practitioner 7416355797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians

Practice addresses (Care Compare)

810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone (828) 326-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center Current Accepting new patients
Catawba Valley Medical Center CurrentSince Aug 23, 2021 Accepting new patients
Catawba Valley Medical Center CurrentSince Aug 23, 2021 Accepting new patients

Locations

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1407522758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822",
            "city": "GLEN ALPINE",
            "state": "NC",
            "postal_code": "286280822",
            "telephone_number": "828-443-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "STACIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.