Individual provider Active NPI

Kacey L Stark

  • Family Nurse Practitioner
  • New Bern, NC
National Provider Identifier
1699584581
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5023171 Issued in NC
Practice address
2000 Neuse Blvd
New Bern, NC 28560-3449
Phone
(252) 633-8111
NPI assigned
Jan 6, 2025
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5023171 NC Primary
Flight Registered Nurse 163WF0300X 194691 NC

Addresses

Primary practice location

2000 Neuse Blvd
New Bern, NC 28560-3449

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (800) 828-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20251203002350 NC Practitioner - Nurse Practitioner 3971096488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Physicians of Craven County PLLCGroup PAC ID 0042106478, 17 clinicians

Practice addresses (Care Compare)

2000 Neuse Blvd
New Bern, NC 28560-3449
Phone (252) 633-8119

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
194691NCMDFlight Registered Nurse
5023171NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Craven County, PLLC CurrentSince Oct 1, 2025 Accepting new patients
Emergency Medicine Physicians of Carteret County, PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

4535 Dressler Rd NW
Canton, OH 44718
Phone (330) 994-4409

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 1

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": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1699584581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "800-828-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603449",
            "telephone_number": "252-633-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "KACEY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5023171",
            "primary": true
        },
        {
            "code": "163WF0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Flight",
            "state": "NC",
            "license": "194691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.