NPIMap

Individual provider Active NPI

Stacy R Ingram-Hanson, NP

  • Nurse Practitioner
  • Hopewell, VA
National Provider Identifier
1699748905
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0357112 Issued in VA
Practice address
815 W Poythress St
Hopewell, VA 23860-2532
Phone
(804) 458-8557
Fax
(804) 541-7113
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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 0024164728 VA
Nurse Practitioner 363L00000X 0357112 VA Primary

Addresses

Primary practice location

815 W Poythress St
Hopewell, VA 23860-2532

Mailing address

815 W Poythress St
Hopewell, VA 23860-2532
Phone (804) 458-8557

Other identifiers 1

IdentifierTypeStateIssuer
010297427MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080430000857 VA Practitioner - Nurse Practitioner 9335228436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appomattox River Primary Care LLCGroup PAC ID 8022493469, 6 clinicians

Practice addresses (Care Compare)

815 W Poythress St
Hopewell, VA 23860-2532
Phone (804) 458-8557

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Midlothian, VA, CCN 497538
  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Southside Regional Home Health Home health agency, Petersburg, VA, CCN 497072
  • Commonwealth Home Care Home health agency, Richmond, VA, CCN 497703
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • John Randolph Medical Center Hospital, Hopewell, VA, CCN 490020
  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0357112VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appomattox River Primary Care, LLC CurrentSince Aug 12, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3512 Boulevard
Colonial Hgts, VA 23834
Phone (804) 520-1110

815 W Poythress St
Hopewell, VA 23860
Phone (804) 458-3429

Interoperability endpoints

  • Direct secure messaging: stacy.ingramhanson@hca6.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1699748905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W POYTHRESS ST",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602532",
            "telephone_number": "804-458-8557",
            "fax_number": "804-541-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W POYTHRESS ST",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602532",
            "telephone_number": "804-458-8557",
            "fax_number": "804-541-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM-HANSON",
        "first_name": "STACY",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164728",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0357112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010297427",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.