Stacey Thompson Mietus, APRN, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6409 Issued in MN

Practice address

428 Minnesota St Ste 500
Saint Paul, MN 55101-2666

Phone

(612) 662-9604

Fax

(612) 474-9072

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified 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 and National Provider Directory roles.

• Mietus NP Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1851857106
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1447667456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171615",
            "telephone_number": "612-226-2912",
            "fax_number": "612-474-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 MINNESOTA ST STE 500",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012666",
            "telephone_number": "612-662-9604",
            "fax_number": "612-474-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIETUS",
        "first_name": "STACEY",
        "middle_name": "THOMPSON",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2470293",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Radiology Outpatient Imaging, LLC
• Midwest Stabilization Services Inc
• Deborah Kim Mielke, M.D.
• Matthew Lester Mielke, M.D.
• Mietus NP Mental Health, LLC
• Travis Nelson Mighell, APRN, CRNA
• Mighty Oak Chiropractic, PLLC
• Amber Lee Mike
• Elizabeth Mikel
• Mikemarekcounseling

• Psychiatric/Mental Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.