Individual provider Active NPI

Stacie Sowell, FNP-C

  • Family Nurse Practitioner
  • Somerville, TN
National Provider Identifier
1710579388
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29045 Issued in TN
Practice address
25 Woodbridge Rd
Somerville, TN 38068-1242
Phone
(901) 465-6353
Fax
(833) 902-3599
NPI assigned
Feb 5, 2021
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 29045 TN
Family Nurse Practitioner 363LF0000X 29045 TN Primary

Addresses

Primary practice location

25 Woodbridge Rd
Somerville, TN 38068-1242

Mailing address

25 Woodbridge Rd
Somerville, TN 38068-1242
Phone (901) 465-6353

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
I20210426000294 TN Practitioner - Nurse Practitioner 0648686717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Tennessee LLCGroup PAC ID 7416261482, 56 clinicians

Practice addresses (Care Compare)

5865 Ridgeway Ctr Pkwy
Memphis, TN 38120-4032
Phone (337) 991-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29045TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David L Seaton CurrentSince Jul 4, 2021 Accepting new patients
Curana Health of Tennessee LLC Nurse Practitioner CurrentSince Jan 6, 2023 Accepting new patients
Professional Imaging of Tennessee PastSince Aug 1, 2021 Accepting new patients
Wilder Clinic PastSince Jan 22, 2023 Accepting new patients

Locations

5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295

16530 US Highway 64
Somerville, TN 38068
Phone (901) 813-8138

16532 US Highway 64
Somerville, TN 38068
Phone (901) 560-2920

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1710579388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODBRIDGE RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380681242",
            "telephone_number": "901-465-6353",
            "fax_number": "833-902-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODBRIDGE RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380681242",
            "telephone_number": "901-465-6353",
            "fax_number": "833-902-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWELL",
        "first_name": "STACIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "29045",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, TN

Sources for this page

Verify at the official NPI Registry.