Kelly Joy Stake, MSN, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN.393241 Issued in OH

Practice address

5550 Venture Dr
Parma, OH 44130-9315

Phone

(216) 201-2000

NPI assigned

Jun 23, 2023

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

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of CuyahogaGroup PAC ID 6305827528, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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.

• County of Cuyahoga

  dba Cuyahoga County Board of Health

  • Public Health or Welfare Agency
  • Parma, OH
  • NPI 1164577904
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1578249686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 PEARL RD",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441302007",
            "telephone_number": "419-651-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 VENTURE DR",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441309315",
            "telephone_number": "216-201-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKE",
        "first_name": "KELLY",
        "middle_name": "JOY",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "RN.393241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Augustine Manor (St Augustine Manor doing business as Holy Family Hospice)
• St Augustine Manor (Holy Family Home Health Care)
• Shawn Even Cutlip Stacey
• Motria Maria Stachur, OTR/L
• Stafford Services, Inc.
• Bianca M Stallings, REGISTERED NURSE
• Katelyn Stanton McClure, LSW
• Cassandra N Stargen, LMT
• Starlight Counseling LLC
• Tracy L Starr

• Women's Health Nurse Practitioner in Parma, OH
• Providers in Parma, OH by specialty
• Women's Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.