Individual provider Active NPI

Staci Diane Thompson, FNP-C

  • Family Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1417400755
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006408A Issued in IN
Practice address
2330 S. Dixon Road
American Health Network
Kokomo, IN 46902
Phone
(765) 455-5400
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006408A IN Primary

Addresses

Primary practice location

2330 S. Dixon Road
American Health Network
Kokomo, IN 46902

Mailing address

2330 S. Dixon Road
American Health Network
Kokomo, IN 46902
Phone (765) 455-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address staci.thompsonfnp.p7@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160913002077 IN Practitioner - Nurse Practitioner 6507152808 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

2008 N Walnut St
Hartford City, IN 47348-1364
Phone (765) 329-6662

3719 S Western Ave
Marion, IN 46953-4828
Phone (765) 293-8485

4152 W State Rd
Suite 56
Hanover, IN 47243-9070
Phone (901) 351-1791

811 W Main St
Peru, IN 46970-1742
Phone (765) 470-4076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006408AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 1, 2024 Accepting new patients
FC Indiana, LLC CurrentSince Sep 9, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 1, 2024 Accepting new patients
FC Indiana, LLC CurrentSince Sep 9, 2024 Accepting new patients
American Health Network of Indiana, LLC Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

1159 W Jefferson St
Ste 204
Franklin, IN 46131

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

Interoperability endpoints

  • Direct secure messaging: staci.thompsonfnp.p7@direct.ahni.nextgenshare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1417400755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S. DIXON ROAD",
            "address_2": "AMERICAN HEALTH NETWORK",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-455-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S. DIXON ROAD",
            "address_2": "AMERICAN HEALTH NETWORK",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-455-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STACI",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006408A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staci.thompsonfnp.p7@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2330 S. Dixon Road",
            "address_2": "American Health Network",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.