Stacy Jo Kennedy, FNP- BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30260.1816 Issued in WY

Practice address

1453A Dewar Dr
Rock Springs, WY 82901-5812

Phone

(307) 382-2466

Fax

(888) 395-0359

NPI assigned

Oct 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Casper CardiologyGroup PAC ID 2062712029, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Sweetwater County Hospital, Rock Springs, WY, CCN 531318

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Casper Cardiology

  • Cardiovascular Disease Physician
  • Casper, WY
  • NPI 1447627492

  WY

  Medicare reassignment Care Compare group NPD
• Cedars Health

  • Primary Care Clinic/Center
  • Casper, WY
  • NPI 1306196209
  NPD

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

• Memorial Hospital of Sweetwater County

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1669947610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 DOUGLAS DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829013148",
            "telephone_number": "307-371-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453A DEWAR DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015812",
            "telephone_number": "307-382-2466",
            "fax_number": "888-395-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "STACY",
        "middle_name": "JO",
        "credential": "FNP- BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "30260.1816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cielette M Karn, MD
• Samer E Kattan, MD
• Elisabeth Ann Keefe, LCSW
• Amanda Sue Keen
• Maria L Kendall, DPT
• Rhonda Marie Kettering, MS, NCC,LPC.CAP
• Cameron Franklin Keys
• Mansour Eltaher Khaddr, M.D.
• Kim C. Kikuts, BS
• Helen D Kim-Sholey, O. D.

• All providers in Rock Springs, WY
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.