Active NPI
Stacy Laine Gregory, ACNP
- Acute Care Nurse Practitioner
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 601016
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| AP125238 | TX | MD | Nurse Practitioner |
| 601016 | TX | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Texas Emergency Physicians, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Highland Emergency Group, LLC | Nurse Practitioner | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital Jacksonville | Current | Accepting new patients | |
| Mother Frances Hospital Regional Health Care Center | Current | 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
- 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.
-
- Emergency Medicine Physician
- Longview, TX
- NPI 1114607611
Nurse Practitioner
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Critical Access Hospital
- Jacksonville, TX
- NPI 1952306672
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- Emergency Medicine Physician
- Shreveport, LA
- NPI 1154913861
Nurse Practitioner
-
- Urgent Care Clinic/Center
- Lakeway, TX
- NPI 1285088161
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Certified Registered Nurse Anesthetist
- Tyler, TX
- NPI 1629185210
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.