Stacey D Ervin, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

630620 Issued in TX

Practice address

3111 McCann Rd
Longview, TX 75605-7842

Phone

(903) 753-1212

Fax

(214) 712-2487

NPI assigned

Jun 14, 2006

Last updated

Nov 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 TX, OK, AR3 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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacey.ervin.1@30469.direct.athenahealth.com

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.

• Advanced Healing Solutions, PLLC

  dba Restorative Mobile Wound Care of Northeast Texas

  • Medical Specialty Clinic/Center
  • Avery, TX
  • NPI 1588429625
  Medicare reassignment NPD Authorized official
• Texarkana Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1871813345

  Nurse Practitioner

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TX

  Medicare reassignment NPD
• Virtual Medical Solutions, LLC

  dba Carter County Wound Care

  • Medical Specialty Clinic/Center
  • Ardmore, OK
  • NPI 1801538467
  Medicare reassignment NPD
• Lambda Medical, PLLC

  • Medical Specialty Clinic/Center
  • Paris, TX
  • NPI 1245002070

  Nurse Practitioner

  NPD Authorized official
• Advanced Healing Solutions Ar

  dba Restorative Mobile Wound Care of SW Arkansas

  • Medical Specialty Clinic/Center
  • Horatio, AR
  • NPI 1396562914
  Authorized official Same address or phone
• Emcare-Dtxemergency Physicians PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1285709600

  Nurse Practitioner

  NPD (past)
• Four States Emergency Physicians

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1922051440
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Physician Assistant
  • Texarkana, TX
  • NPI 1558314062
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1942253083
  NPD (past)
• Access Health Family and Urgent Care, LLC

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1275403958
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1487697538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 UTAH ST",
            "city": "AVERY",
            "state": "TX",
            "postal_code": "755542600",
            "telephone_number": "903-908-0352",
            "fax_number": "903-798-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 MCCANN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057842",
            "telephone_number": "903-753-1212",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "STACEY",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "630620",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP113426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Hibbs Erickstad, MD
• Landon Taylor Erickstad, MD
• Mark D Erickstad, M.D.
• Nils Siegfried Erikson, M.D.
• Renee Elizabeth Ernst, NP-C
• David Randolph Erwin, M.D.
• Esc IV LP (Brookdale Longview)
• Stacie Estrella
• Et Transitional Living
• Holly Rebecca Etheredge, APRN

• Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.