NPIMap

Individual provider Active NPI

Stacie Nicole O'Neil, APRN

  • Gerontology Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1508533712
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
3016583 Issued in KY
Practice address
100 W Market St Ste 2
Louisville, KY 40202-1332
Phone
(502) 587-8000
NPI assigned
Aug 25, 2021
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 3016583 KY
Family Nurse Practitioner 363LF0000X 3016583 KY
Gerontology Nurse Practitioner 363LG0600X 3016583 KY Primary

Addresses

Primary practice location

100 W Market St Ste 2
Louisville, KY 40202-1332

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 559-9412

Other names 1

  • Stacie Nicole Harris Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006001386 KY Practitioner - Nurse Practitioner 0840698890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

100 W Market St
Suite 2
Louisville, KY 40202-1332
Phone (502) 587-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3016583KYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

100 W Market St
Ste 2
Louisville, KY 40202

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

850 S 28th St
Ste 104
Louisville, KY 40211
Phone (502) 394-5678

Interoperability endpoints

  • Direct secure messaging: sharris71708@direct.nortonhealthcare.org

Organizations & group practices 4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1508533712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-559-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MARKET ST STE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021332",
            "telephone_number": "502-587-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "STACIE",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "KY",
            "license": "3016583",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016583",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "3016583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "HARRIS",
            "middle_name": "NICOLE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.