NPIMap

Individual provider Active NPI

Amy Stark

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1477098754
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
208100 Issued in OK
Practice address
101 W Hefner Rd Ste 100
Oklahoma City, OK 73114-6631
Phone
(405) 896-8058
Fax
(855) 223-1999
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016042121 MO
Family Nurse Practitioner 363LF0000X 208100 OK Primary

Addresses

Primary practice location

101 W Hefner Rd Ste 100
Oklahoma City, OK 73114-6631

Mailing address

101 W Hefner Rd
Oklahoma City, OK 73114-6631
Phone (405) 896-8058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220701002735 OK Practitioner - Nurse Practitioner 1153605589 Reassigns benefits to 1 organization
I20240617000675 FL Practitioner - Nurse Practitioner 1153605589 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abode Care Partners Al VB LLCGroup PAC ID 1658403704, 48 clinicians
SHC Medical Partners of Florida, LLCGroup PAC ID 7618046517, 9 clinicians

Practice addresses (Care Compare)

4400 Bayou Blvd
Suite 54a
Pensacola, FL 32503-1909
Phone (727) 323-3611

785 S 2ND St
Defuniak Springs, FL 32435-4903
Phone 80080765554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208100OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SHC Medical Partners of Florida, LLC CurrentSince Mar 11, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince May 13, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince May 13, 2024 Accepting new patients
Physician Housecalls LLC CurrentSince Jun 27, 2022 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince May 13, 2024 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince May 13, 2024 Accepting new patients

Locations

785 S 2nd St
Defuniak Springs, FL 32435
Phone (850) 892-2176

4400 Bayou Blvd
Ste 54A
Pensacola, FL 32503
Phone (727) 323-3611

4033 Beaver Ln
Pt Charlotte, FL 33952
Phone (941) 212-2748

12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

101 W Hefner Rd
Oklahoma City, OK 73114
Phone (405) 896-8058

101 W Hefner Rd
Ste 100
Oklahoma City, OK 73114
Phone (405) 896-8058

919 Medical Park Dr
Mountain City, TN 37683
Phone (423) 727-7800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19281/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1477098754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W HEFNER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146631",
            "telephone_number": "405-896-8058",
            "fax_number": "855-223-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W HEFNER RD STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146631",
            "telephone_number": "405-896-8058",
            "fax_number": "855-223-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016042121",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "208100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.