Stacey Renee Warden

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-102742 Issued in AL

Practice address

34617 Al Highway 75
Fyffe, AL 35971-3488

Phone

(256) 623-5242

Fax

(256) 623-5243

NPI assigned

May 4, 2020

Last updated

Jul 9, 2024By the provider in NPPES

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 AL

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Alabama Health Services, Inc.Group PAC ID 4082522883, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dekalb Regional Medical Center Hospital, Fort Payne, AL, CCN 010012

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Alabama Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Scottsboro, AL
  • NPI 1659448983
  Medicare reassignment Care Compare group NPD
• Northeast Alabama Health Services, Inc.

  dba Northeast Alabama Health Services Inc - North Sand Mountain

  • Federally Qualified Health Center (FQHC)
  • Bryant, AL
  • NPI 1356498505
  NPD
• Northeast Alabama Health Services, Inc.

  dba Northeast Alabama Health Services Inc - Fyffe

  • Federally Qualified Health Center (FQHC)
  • Fyffe, AL
  • NPI 1104973353
  NPD (past)

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

• HH Health System - Dekalb, LLC

  dba DeKalb Regional Medical Center

  • General Acute Care Hospital
  • Fort Payne, AL
  • NPI 1770344665
  Care Compare affiliation

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1679194351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866",
            "telephone_number": "205-644-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34617 AL HIGHWAY 75",
            "city": "FYFFE",
            "state": "AL",
            "postal_code": "359713488",
            "telephone_number": "256-623-5242",
            "fax_number": "256-623-5243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Freedom Ln",
            "address_purpose": "LOCATION",
            "city": "Scottsboro",
            "state": "AL",
            "postal_code": "357693763",
            "country_code": "US",
            "telephone_number": "256-574-5508",
            "fax_number": "256-259-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13624 County Road 8",
            "address_purpose": "LOCATION",
            "city": "Woodville",
            "state": "AL",
            "postal_code": "357766162",
            "country_code": "US",
            "telephone_number": "256-776-5615",
            "fax_number": "256-776-5617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3840 Gault Ave N",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359675211",
            "country_code": "US",
            "telephone_number": "256-844-4975",
            "fax_number": "256-844-4978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21680 Al Highway 79",
            "address_purpose": "LOCATION",
            "city": "Scottsboro",
            "state": "AL",
            "postal_code": "357685904",
            "country_code": "US",
            "telephone_number": "256-587-3050",
            "fax_number": "256-587-3508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29810 Al Highway 71",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AL",
            "postal_code": "359585240",
            "country_code": "US",
            "telephone_number": "256-597-4114",
            "fax_number": "256-597-4115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Main St N",
            "address_purpose": "LOCATION",
            "city": "Section",
            "state": "AL",
            "postal_code": "357717168",
            "country_code": "US",
            "telephone_number": "256-228-3471",
            "fax_number": "256-228-7289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "STACEY",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-102742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Lee Rains, RPH
• Cheree Reed Rains, RPH
• Calvin Oneal Sanders Jr., DMD
• Kimberly Kay Simpson, LPTA
• T & N Inc,

• Family Nurse Practitioner in Fyffe, AL
• Providers in Fyffe, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.