Individual provider Active NPI

Stacy Dycus

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1710529136
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN0000026498 Issued in TN
Practice address
511 8TH St
Clarksville, TN 37040-3093
Phone
(931) 920-7200
NPI assigned
Oct 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN0000026498 TN Primary

Addresses

Primary practice location

511 8TH St
Clarksville, TN 37040-3093

Mailing address

3134 Holly PT
Clarksville, TN 37043-8435
Phone (615) 594-3581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200414003233 TN Practitioner - Nurse Practitioner 4284064262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Tennessee, Inc.Group PAC ID 9739088113, 114 clinicians

Practice addresses (Care Compare)

511 8TH St
Clarksville, TN 37040-3093
Phone (888) 291-4357

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000026498TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jan 18, 2020 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jan 18, 2020 Accepting new patients

Locations

511 8th St
Clarksville, TN 37040
Phone (615) 595-8383

620 Gallatin Pike S
Madison, TN 37115
Phone (615) 460-4300

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1710529136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 HOLLY PT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438435",
            "telephone_number": "615-594-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 8TH ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403093",
            "telephone_number": "931-920-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCUS",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000026498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.