Stacie Lynn Butler, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R169695 Issued in MD

Practice address

4231 N Woods TRL
Hampstead, MD 21074-3128

Phone

(410) 374-9391

Fax

(410) 374-1866

NPI assigned

Oct 17, 2011

Last updated

Oct 17, 2011By 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 identifiers 1

Other names 1

• Stacie Lynn Tyler Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MNR Industries, LLC

  dba ExpressCare of Bel Air

  • Urgent Care Clinic/Center
  • Bel Air, MD
  • NPI 1457478703
  Medicare reassignment Care Compare group NPD
• MNR Industries, LLC

  dba ExpressCare of Bowie

  • Urgent Care Clinic/Center
  • Bowie, MD
  • NPI 1093130924

  DC

  Medicare reassignment NPD
• U N I Medical Care Inc

  • Urgent Care Clinic/Center
  • Westminster, MD
  • NPI 1790962371
  Medicare reassignment NPD
• MNR Industries LLC

  dba ExpressCare of Mount Airy

  • Urgent Care Clinic/Center
  • Mount Airy, MD
  • NPI 1073963146
  NPD
• MNR Industries, LLC

  dba ExpressCare of Largo

  • Urgent Care Clinic/Center
  • Upper Marlboro, MD
  • NPI 1194195008
  NPD
• MNR Industries, LLC

  dba ExpressCare of Urbana

  • Urgent Care Clinic/Center
  • Frederick, MD
  • NPI 1215648829
  NPD
• MNR Industries, LLC

  • Urgent Care Clinic/Center
  • Bel Air, MD
  • NPI 1649089418
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1710262118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743128",
            "telephone_number": "410-374-9391",
            "fax_number": "410-374-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743128",
            "telephone_number": "410-374-9391",
            "fax_number": "410-374-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R169695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "R169695",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "TYLER",
            "middle_name": "LYNN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jon Michael Breakey, PT DPT
• Bridginglife, Inc
• Bridginglife, Inc
• Bridginglife, Inc
• Anthony Brocato Jr., RPH
• Emma Cambley
• Candace Crew LLC
• Carroll Family Medicine, LLC
• Carroll Health Group, LLC
• Carroll Medical Group (LifeBridge Community Physician)

• Family Nurse Practitioner in Hampstead, MD
• Providers in Hampstead, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.