Individual provider Active NPI

Stacy Laine Gregory, ACNP

  • Acute Care Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1528483591
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
601016 Issued in TX
Practice address
1809 Capital Dr
Tyler, TX 75701-8438
Phone
(903) 509-4499
Fax
(903) 509-4490
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 601016 TX Primary
Nurse Practitioner 363L00000X AP125238 TX

Addresses

Primary practice location

1809 Capital Dr
Tyler, TX 75701-8438

Mailing address

13261 S Hillcreek Rd
Whitehouse, TX 75791-5215
Phone (903) 571-8545

Other practice location 1

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 541-4500

Other practice location 2

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-4262

Other practice location 3

8389 S Broadway Ave
Tyler, TX 75703-5408
Phone (903) 606-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140613000156 TX Practitioner - Nurse Practitioner 8628292612 Reassigns benefits to 5 organizations
I20220907003346 LA Practitioner - Nurse Practitioner 8628292612 Reassigns benefits to 1 organization

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
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP125238TXMDNurse Practitioner
601016TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Texas Emergency Physicians, PLLC Nurse Practitioner CurrentSince Oct 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince May 2, 2016 Accepting new patients
Highland Emergency Group, LLC Nurse Practitioner CurrentSince Jul 24, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince May 2, 2016 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince May 2, 2016 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince May 2, 2016 Accepting new patients
Mother Frances Hospital Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

8389 S Broadway Ave
Tyler, TX 75703
Phone (903) 606-4129

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: sgregory100325@christushealth.direct-ci.net

Organizations & group practices 8

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 1

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": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1528483591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13261 S HILLCREEK RD",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757915215",
            "telephone_number": "903-571-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 CAPITAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018438",
            "telephone_number": "903-509-4499",
            "fax_number": "903-509-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757665822",
            "country_code": "US",
            "telephone_number": "903-541-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-4262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8389 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757035408",
            "country_code": "US",
            "telephone_number": "903-606-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "STACY",
        "middle_name": "LAINE",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "601016",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP125238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.