NPIMap

Individual provider Active NPI

Stacy Lynn Hansen-Goodell, FNP-C

  • Family Nurse Practitioner
  • Greenville, MI
National Provider Identifier
1689394660
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704227132 Issued in MI
Practice address
615 S Bower St
Greenville, MI 48838-2614
Phone
(616) 225-9330
Fax
(616) 754-4043
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 4704227132 MI Primary

Addresses

Primary practice location

615 S Bower St
Greenville, MI 48838-2614

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shansengoodell1023086@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221207001926 MI Practitioner - Nurse Practitioner 5890164230 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

5 Atkinson Dr
302 Corewell Health Medical Group West
Ludington, MI 49431-1906
Phone (616) 267-8700

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704227132MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reed City Hospital Corporation CurrentSince Jan 2, 2023 Accepting new patients
Pennock Hospital Nurse Practitioner CurrentSince Jan 2, 2023 Accepting new patients
Spectrum Health United CurrentSince Jan 2, 2023 Accepting new patients
Newaygo County General Hospital Association CurrentSince Jan 2, 2023 Accepting new patients
Spectrum Health United CurrentSince Jan 2, 2023 Accepting new patients
Newaygo County General Hospital Association CurrentSince Jan 2, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 2, 2023 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jan 2, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 2, 2023 Accepting new patients
Pennock Hospital CurrentSince Jan 2, 2023 Accepting new patients
Reed City Hospital Corporation CurrentSince Jan 2, 2023 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jan 2, 2023 Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

145 Michigan St NE
Ste 5200
Grand Rapids, MI 49503
Phone (616) 486-5933

100 Michigan St NE
#8458
Grand Rapids, MI 49503

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

1009 W Green St
Hastings, MI 49058
Phone (269) 945-1212

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

7 Atkinson Dr
Ste 115
Ludington, MI 49431
Phone (231) 843-2571

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

4499 220th Ave
Reed City, MI 49677
Phone (231) 832-5817

8333 Felch St
Zeeland, MI 49464
Phone (616) 741-3790

Interoperability endpoints

  • Direct secure messaging: shansengoodell1023086@epic00.corewelldirect.org
  • Direct secure messaging: shansengoodell1023086@epic00.shdirect.org

Organizations & group practices 12

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 5

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": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1689394660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S BOWER ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382614",
            "telephone_number": "616-225-9330",
            "fax_number": "616-754-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN-GOODELL",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704227132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shansengoodell1023086@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

Verify at the official NPI Registry.