Stacia N Boyer

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN.CNP.025468 Issued in OH

Practice address

1611 27TH St Ste 101
Portsmouth, OH 45662-6932

Phone

(740) 356-7337

Fax

(740) 356-6304

NPI assigned

Aug 8, 2019

Last updated

Dec 18, 2020By 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 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Somc Medical Care Foundation, Inc.

  • Family Medicine Physician
  • Portsmouth, OH
  • NPI 1457467227
  Medicare reassignment NPD
• Somc Medical Care Foundation, Inc.

  dba Somc Radiology Associates

  • Diagnostic Radiology Physician
  • Portsmouth, OH
  • NPI 1366686230
  NPD

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1528613346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 27TH ST STE 101",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626932",
            "telephone_number": "740-356-7337",
            "fax_number": "740-356-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "STACIA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.025468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0365027",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100619200",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacia.boyer@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1611 27th Street",
            "address_2": "Fulton Bldg Suite 101",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bobby Boyd, CDCA, QMHS
• Christina Boyd, LICDC-CS, LISW
• Jacqueline A Boyd
• Lindsie Boyd
• Tresa Boyd
• Rhonda Evonne Boyud, LPN
• Brianna Brabson
• Brace Yourself Orthodontics, Inc. / Jay Parekh DDS, Ms (Brace Yourself Orthodontics)
• Aaron Joeseph Bradley, LICDC.162763
• Cindi Michelle Bradley, CNP

• Pediatric Nurse Practitioner in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.