Staci Michelle McKean, ACNS

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

700711 Issued in TX

Practice address

3410 Worth St
Suite 250
Dallas, TX 75246-2003

Phone

(214) 820-6856

NPI assigned

Oct 19, 2012

Last updated

Mar 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 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Certified Nurse Specialist, 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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1538412176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462003",
            "telephone_number": "214-820-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEAN",
        "first_name": "STACI",
        "middle_name": "MICHELLE",
        "credential": "ACNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2023-03-07",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "700711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "700711",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX AUTHORIZATION",
            "identifier": "13218",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "90194305",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "AP122596",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smckean452481@direct.sw.org",
            "affiliation": "N",
            "address_1": "3410 Worth St",
            "address_2": "Suite 250",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752462003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dana Marie McKay, RD, LD
• Donald Lee McKay, M.D.
• Howard Frederick McKay, APRN, FNP-C, CPNP-AC
• Tyeese McKay
• Alyssa McKean
• Jaya Ariel McKeel
• Jennifer Lee McKeever, L.AC.
• Heidi Louise McKellar, MD
• Krista Delaney McKelvin, LPC
• Brandy Leigh McKelvy, COTA

• Adult Health Clinical Nurse Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Adult Health Clinical Nurse Specialist in Texas

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

Verify at the official NPI Registry.