Stacey Lynn Phillips, MSN, FNP
Individual provider Active NPI Family Nurse Practitioner · Somerville, TN
NPI 1710136718 · NPPES record last updated Oct 8, 2015
Key facts
- NPI
- 1710136718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 13658 (TN)
- Practice address
- 25 Woodbridge Rd
Suite a
Somerville, TN 38068-1242 - Phone
- (901) 465-6353
- Fax
- (901) 465-5948
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Memphis Hospital Medical College, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Methodist Healthcare Community Care Associates
Practice addresses (Care Compare)
1803 Union Ave
Suite 2
Memphis, TN 38104-3910
Phone (901) 722-3136
8071 Winchester Rd
Memphis, TN 38125-8206
Phone (901) 756-6056
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100913000174 | TN | Practitioner - Nurse Practitioner | 9234254475 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13658 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Healthcare Community Care Associates | Current | Accepting new patients | |
| Methodist Healthcare Community Care Associates | Current |
Accepting new patients | |
| Methodist Heatlhcare Community Care Associates | Current |
Accepting new patients | |
| Wilder Clinic | Past | Accepting new patients | |
| Adult Primary Care of Memphis PC | Past | Accepting new patients |
Locations
8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035
8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001
1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954
Interoperability endpoints
- sphillips33393@mlh.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13658 | TN | Yes |
Addresses
Primary practice location
25 Woodbridge Rd
Suite a
Somerville, TN 38068-1242
Mailing address
25 Woodbridge Rd
Suite a
Somerville, TN 38068-1242
Phone (901) 465-6353
Other providers in Somerville, TN
- Kristena Terry Partridge
- Paul Scates M.D. Family Medicine
- Lydia Perkins
- Jessica Lynn Perry
- Anna Petrie
- Phyllis Dickinson-Branch
- Madison Pierski
- Pamela C Pierski
- Professional Care Services of West TN Inc
- Professional Care Services of West TN, Inc.
All providers in Somerville, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.