Stacy Shante Redmond, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

903311 Issued in MS

Practice address

3103 Sierra CT
Columbus, MS 39705-1807

Phone

(662) 889-7528

NPI assigned

Aug 24, 2022

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 MS

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

Practice roles

Locations

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.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1417676271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 SIERRA CT",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051807",
            "telephone_number": "662-889-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 SIERRA CT",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051807",
            "telephone_number": "662-889-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "STACY",
        "middle_name": "SHANTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "903311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RCG Mississippi, Inc. (Fresenius Medical Care Golden Triangle Home Therapies)
• RCG Mississippi, Inc. (RCG Columbus)
• RCG Mississippi, Inc. (Lowndes County Dialysis)
• Real Life Real Faith LLC
• Recovery House, Inc.
• Donna M Reece, CRNA
• Hunter Lynn Reed, DO
• John E. Reed Jr., M.D.
• Lora Marie Reed, OTR/L
• Quintara A Reese

• Primary Care Nurse Practitioner in Columbus, MS
• Providers in Columbus, MS by specialty
• Primary Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.