Individual provider Active NPI

Stacey Stinger, ARNP

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1619374451
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9438343 Issued in FL
Practice address
4130 Tamiami TRL Unit 202
Port Charlotte, FL 33952-9207
Phone
(419) 787-7111
Fax
(941) 764-0872
NPI assigned
Nov 21, 2014
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP141095 ME
Family Nurse Practitioner 363LF0000X ARNP9438343 FL Primary

Addresses

Primary practice location

4130 Tamiami TRL Unit 202
Port Charlotte, FL 33952-9207

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other names 1

  • Stacey Cannady Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161020000235 FL Practitioner - Nurse Practitioner 7012231046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9438343FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Oct 3, 2016 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 3, 2016 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

4130 Tamiami Trl
Unit 202
Pt Charlotte, FL 33952
Phone (941) 629-1814

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: stacey.lagasse.1@4290.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1619374451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 TAMIAMI TRL UNIT 202",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529207",
            "telephone_number": "419-787-7111",
            "fax_number": "941-764-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINGER",
        "first_name": "STACEY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP141095",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9438343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "CANNADY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.