Jennifer Stakias, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

18172 Issued in TN

Practice address

415 Broad St
Suite 410
Kingsport, TN 37660-4263

Phone

(423) 239-9737

Fax

(423) 398-5500

NPI assigned

Nov 22, 2013

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 TN, VA, NC3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Bayada Home Health Care, Inc. Home health agency, Raleigh, NC, CCN 347243
• Amedisys Home Health Home health agency, Durham, NC, CCN 347110
• Vidant Duplin Hospital Hospital, Kenansville, NC, CCN 340120

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Eventus WH Southeast, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1487494811

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth, PLLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1548759392

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus Value Care, LLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1013680503
  Medicare reassignment NPD
• Eventus Wholehealth Aco LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Concord, NC
  • NPI 1023796307

  Nurse Practitioner

  Medicare reassignment NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236

  VA

  Medicare reassignment
• Eventus WH PLLC Care, LLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1639990658
  NPD

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

• Amedisys North Carolina, LLC

  • Home Health Agency
  • Durham, NC
  • NPI 1083669873
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Raleigh, NC
  • NPI 1285876250
  Care Compare affiliation
• Duplin General Hospital Incorporated

  • General Acute Care Hospital
  • Kenansville, NC
  • NPI 1508832833
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1437589710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-239-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROAD ST",
            "address_2": "SUITE 410",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604263",
            "telephone_number": "423-239-9737",
            "fax_number": "423-398-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKIAS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "18172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Miller Spivey, PHARMD
• Spring Oak Kingsport LLC
• Douglas J Springer, M.D
• Kristin Danielle Sproles, BCBA
• James Alexander Stakias, DDS
• Michael Donald Stallard, MD
• Aimee Mullins Stamper, MA
• Gregory Alan Stancel, MD
• Kiela Breanne Stanley, RRA. RT(R)
• Cheryl Stanski, MD

• Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.