Individual provider Active NPI

Stacey Elizabeth Hunt, FNP

  • Family Nurse Practitioner
  • O'Fallon, MO
National Provider Identifier
1558929471
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019013481 Issued in MO
Practice address
2630 Highway K
O Fallon, MO 63368-6624
Phone
(636) 240-5454
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019013481 MO Primary

Addresses

Primary practice location

2630 Highway K
O Fallon, MO 63368-6624

Mailing address

2630 Highway K
O Fallon, MO 63368-6624
Phone (636) 240-5454

Other practice location 1

811 S 13 Hwy Ste A
Lexington, MO 64067-1572
Phone (314) 440-0801

Other names 1

  • Stacey Elizabeth Brennan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20190627000326 MO Practitioner - Nurse Practitioner 5890029722 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

7212 Balson Ave
Saint Louis, MO 63130-3001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Nov 1, 2020 Accepting new patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Aug 7, 2020 Accepting new patients
Samuel U. Rodgers Health Center, Inc CurrentSince Jun 3, 2019 Accepting new patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Jun 3, 2019 Accepting new patients
Physician Groups LC CurrentSince Nov 1, 2020 Accepting new patients

Locations

3825 S Noland Rd
Independence, MO 64055
Phone (816) 254-6002

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

811 S Business Highway 13
Ste A
Lexington, MO 64067
Phone (660) 259-3823

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

2630 Highway K
Ste 100
O Fallon, MO 63368
Phone (636) 240-5454

7334 S Lindbergh Blvd
Saint Louis, MO 63125
Phone (314) 892-8352

1520 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 497-4000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1558929471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 S 13 Hwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MO",
            "postal_code": "640671572",
            "country_code": "US",
            "telephone_number": "314-440-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNT",
        "first_name": "STACEY",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019013481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2630 Highway K",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633686624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BRENNAN",
            "middle_name": "ELIZABETH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.