Individual provider Active NPI

Stacey Bonham-Palas, DNP, AGACNP

  • Acute Care Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1710790050
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
63826 Issued in TN
Practice address
6025 Walnut Grove Rd Ste 111
Memphis, TN 38120-2102
Phone
(901) 271-1000
NPI assigned
Jan 30, 2025
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 63826 TN Primary

Addresses

Primary practice location

6025 Walnut Grove Rd Ste 111
Memphis, TN 38120-2102

Mailing address

7507 Par View CV
Cordova, TN 38016-8301
Phone (212) 203-5855

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
I20250314000972 TN Practitioner - Nurse Practitioner 4486176872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians

Practice addresses (Care Compare)

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38261TNMDPharmacist
63826TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stern Cardiovascular Foundation, Inc CurrentSince Mar 3, 2025 Accepting new patients
Stern Cardiovascular Center, PA CurrentSince Dec 1, 2025 Accepting new patients

Locations

6025 Walnut Grove Rd
Ste 111
Memphis, TN 38120
Phone (901) 226-2000

8060 Wolf River Blvd
Memphis, TN 38138
Phone (901) 271-2272

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1710790050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 PAR VIEW CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380168301",
            "telephone_number": "212-203-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 WALNUT GROVE RD STE 111",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202102",
            "telephone_number": "901-271-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHAM-PALAS",
        "first_name": "STACEY",
        "credential": "DNP, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "63826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.