Individual provider Active NPI

Stacy L Welsh, FNP

  • Family Nurse Practitioner
  • Flushing, MI
National Provider Identifier
1639360522
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704221959 Issued in MI
Practice address
1434 Flushing Rd
Flushing, MI 48433-2229
Phone
(810) 659-3196
NPI assigned
Aug 6, 2007
Last updated
Apr 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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 4704221959 MI Primary

Addresses

Primary practice location

1434 Flushing Rd
Flushing, MI 48433-2229

Mailing address

3495 S Center Rd
Burton, MI 48519-1455
Phone (810) 424-2011

Other identifiers 1

IdentifierTypeStateIssuer
4704221959OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071031000253 MI Practitioner - Nurse Practitioner 1557458064 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704221959MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Urgent Care CurrentSince Jan 1, 2019 Accepting new patients
Asthma, Allergy and Sinus Center, PC Past Accepting new patients
Satnam Medical PLLC PastSince Jan 2, 2009 Accepting new patients

Locations

7192 N Main St
Clarkston, MI 48346
Phone (248) 384-8600

Interoperability endpoints

  • Direct secure messaging: swelsh92094@direct.hurleymc.com

Organizations & group practices 3

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1639360522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 FLUSHING RD",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332229",
            "telephone_number": "810-659-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSH",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704221959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704221959",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, MI

Sources for this page

Verify at the official NPI Registry.