Stacey Johnson, FNP/BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209012102 Issued in IL

Practice address

4 E North St
Coal City, IL 60416-1087

Phone

(815) 518-5755

Fax

(815) 634-4097

NPI assigned

Oct 30, 2014

Last updated

Nov 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey McGuan Former name

Medicare fee-for-service enrollment

Enrolled in IL

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjohnson@direct-address.org
• Direct secure messaging: stacey.mcguan.1@14307.direct.athenahealth.com

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.

• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268
  Medicare reassignment Care Compare group NPD
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • Health Service Clinic/Center
  • Morris, IL
  • NPI 1376658658
  NPD
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511
  NPD (past)

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

• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  Care Compare affiliation

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1679978803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E NORTH ST",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604161087",
            "telephone_number": "815-518-5755",
            "fax_number": "815-634-4097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 E US Route 6",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "IL",
            "postal_code": "604509042",
            "country_code": "US",
            "telephone_number": "815-942-8080",
            "fax_number": "815-941-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACEY",
        "credential": "FNP/BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "MCGUAN",
            "credential": "FNP/BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Coal City, IL
• Providers in Coal City, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.