Individual provider Active NPI

Stacy Renee Thompson, APRN

  • Family Nurse Practitioner
  • Green River, WY
National Provider Identifier
1659719706
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18512.1248 Issued in WY
Practice address
520 Wilkes Dr Ste 13
Green River, WY 82935-4854
Phone
(307) 212-6242
Fax
(307) 212-2246
NPI assigned
Jun 11, 2013
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 18512.1248 WY Primary

Addresses

Primary practice location

520 Wilkes Dr Ste 13
Green River, WY 82935-4854

Mailing address

520 Wilkes Dr Ste 13
Green River, WY 82935-4854
Phone (307) 212-6862

Other identifiers 1

IdentifierTypeStateIssuer
842269506MedicaidWY

Other names 1

  • Stacy Renee Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20140410001044 WY Practitioner - Nurse Practitioner 1951533702 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

Practice addresses (Care Compare)

520 Wilkes Dr
Suite 13
Green River, WY 82935-4854
Phone (307) 212-6242

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Best Care Family Practice LLC Pain Medicine CurrentSince Aug 27, 2019 Accepting new patients
Ozarks Medical Center Pain Medicine Past Accepting new patients

Locations

520 Wilkes Dr
Ste 13
Green River, WY 82935
Phone (307) 212-6242

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 2

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1659719706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WILKES DR STE 13",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829354854",
            "telephone_number": "307-212-6862",
            "fax_number": "307-212-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WILKES DR STE 13",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829354854",
            "telephone_number": "307-212-6242",
            "fax_number": "307-212-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STACY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "18512.1248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842269506",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "ANDERSON",
            "middle_name": "RENEE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green River, WY

Sources for this page

Verify at the official NPI Registry.