Individual provider Active NPI

Stacie Michelle Beaver, CRNP

  • Adult Health Nurse Practitioner
  • Waynesboro, PA
National Provider Identifier
1619241007
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP022183 Issued in PA
Practice address
601 E Main St
Waynesboro, PA 17268-2332
Phone
(717) 765-5088
Fax
(717) 765-5066
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R139236 MD
Adult Health Nurse Practitioner 363LA2200X SP022183 PA Primary

Addresses

Primary practice location

601 E Main St
Waynesboro, PA 17268-2332

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

1000 Norland Ave
Chambersburg, PA 17201-4229
Phone (717) 267-6363

Other practice location 2

100 Eisenhower Dr
Hanover, PA 17331-5241
Phone (717) 646-4201

Other practice location 3

46 Walnut Bottom Rd
Shippensburg, PA 17257-8219
Phone (717) 477-2764

Other practice location 4

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 593-0512

Other practice location 5

455 S Washington St Ste 12
Gettysburg, PA 17325-2516
Phone (717) 339-2875

Other identifiers 3

IdentifierTypeStateIssuer
103802293MedicaidPA
12667440OtherCAQH
1619241007OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120507000401 MD Practitioner - Nurse Practitioner 0446412597 Reassigns benefits to 3 organizations
I20200716003421 PA Practitioner - Nurse Practitioner 0446412597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians
Meritus Urgent Care LLCGroup PAC ID 2163582974, 41 clinicians

Practice addresses (Care Compare)

100 Eisenhower Dr
Wellspan Urgent Care
Hanover, PA 17331-5241
Phone (717) 646-4201

13620 Crayton Blvd
Hagerstown, MD 21742-2335
Phone (240) 313-3100

Hospital & facility affiliations

  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Mar 21, 2023 Accepting new patients
Meritus Urgent Care LLC CurrentSince Dec 12, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group Current Accepting new patients
Urological Center P a CurrentSince Apr 1, 2012 Accepting new patients
Meritus Urgent Care, LLC CurrentSince Dec 12, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Wellspan Medical Group CurrentSince Mar 21, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Vasant Datta MD LLC Past Accepting new patients

Locations

11110 Medical Campus Rd
Ste 228
Hagerstown, MD 21742
Phone (301) 733-0022

17301 Valley Mall Rd
Ste 125
Hagerstown, MD 21740
Phone (301) 790-9236

13620 Crayton Blvd
Hagerstown, MD 21742
Phone (240) 313-3100

1000 Norland Ave
Chambersburg, PA 17201
Phone (717) 267-6363

12 St Paul Dr
Ste 101
Chambersburg, PA 17201
Phone (717) 217-6760

455 S Washington St
Ste 12
Gettysburg, PA 17325
Phone (717) 334-1800

24 Antrim Commons Dr
Greencastle, PA 17225
Phone (717) 593-0512

100 Eisenhower Dr
Hanover, PA 17331
Phone (717) 646-4201

46 Walnut Bottom Rd
Shippensburg, PA 17257
Phone (717) 477-2764

601 E Main St
Waynesboro, PA 17268
Phone (717) 765-5085

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: sbeaver242671@wellspan.direct-ci.com
  • Direct secure messaging: sbeaver1117001@meritus.direct-ci.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1619241007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E MAIN ST",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172682332",
            "telephone_number": "717-765-5088",
            "fax_number": "717-765-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Norland Ave",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172014229",
            "country_code": "US",
            "telephone_number": "717-267-6363",
            "fax_number": "717-217-6937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Eisenhower Dr",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173315241",
            "country_code": "US",
            "telephone_number": "717-646-4201",
            "fax_number": "717-646-4202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46 Walnut Bottom Rd",
            "address_purpose": "LOCATION",
            "city": "Shippensburg",
            "state": "PA",
            "postal_code": "172578219",
            "country_code": "US",
            "telephone_number": "717-477-2764",
            "fax_number": "717-217-4207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Antrim Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "PA",
            "postal_code": "172251623",
            "country_code": "US",
            "telephone_number": "717-593-0512",
            "fax_number": "717-267-6135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 S Washington St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252516",
            "country_code": "US",
            "telephone_number": "717-339-2875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "STACIE",
        "middle_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R139236",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP022183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103802293",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12667440",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619241007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, PA

Sources for this page

Verify at the official NPI Registry.