Individual provider Active NPI

Stacy May McClelland

  • Family Nurse Practitioner
  • San Antonio, FL
National Provider Identifier
1629766985
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11025298 Issued in FL
Practice address
30115 County Road 52 Ste 101
San Antonio, FL 33576-8243
Phone
(813) 467-4244
NPI assigned
Apr 25, 2023
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 APRN11025298 FL Primary

Addresses

Primary practice location

30115 County Road 52 Ste 101
San Antonio, FL 33576-8243

Mailing address

30115 County Road 52 Ste 101
San Antonio, FL 33576-8243
Phone (813) 467-4244

Other practice location 1

6340 Fort King Rd
Zephyrhills, FL 33542-2531
Phone (813) 782-6116

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
I20230719000849 FL Practitioner - Nurse Practitioner 7618337841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

30115 State Rd
52 Suite 101
San Antonio, FL 33576-8243
Phone (813) 467-4244

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Family CurrentSince Aug 1, 2023 Accepting new patients

Locations

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

6340 Fort King Rd
Zephyrhills, FL 33542
Phone (813) 782-6116

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: smcclelland1672908@adventhealth.direct-ci.com

Organizations & group practices 1

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 5

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1629766985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30115 COUNTY ROAD 52 STE 101",
            "city": "SAN ANTONIO",
            "state": "FL",
            "postal_code": "335768243",
            "telephone_number": "813-467-4244",
            "fax_number": "813-467-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30115 COUNTY ROAD 52 STE 101",
            "city": "SAN ANTONIO",
            "state": "FL",
            "postal_code": "335768243",
            "telephone_number": "813-467-4244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6340 Fort King Rd",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335422531",
            "country_code": "US",
            "telephone_number": "813-782-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLELLAND",
        "first_name": "STACY",
        "middle_name": "MAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, FL

Sources for this page

Verify at the official NPI Registry.