Individual provider Active NPI

Stacye Leigh Hopper, APN

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1710939301
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6005 Issued in TN
Practice address
619 Skyline Dr
Jackson, TN 38301-3903
Phone
(731) 422-0213
Fax
(731) 882-5052
NPI assigned
May 16, 2006
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 100792 MT
Family Nurse Practitioner 363LF0000X 6005 TN Primary

Addresses

Primary practice location

619 Skyline Dr
Jackson, TN 38301-3903

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 422-0213

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
I20210330001901 TN Practitioner - Nurse Practitioner 9739138025

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

379 Hospital Blvd
Suite 104
Jackson, TN 38305-2177

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6005TNMDSpeech-Language Pathologist
100792MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springer Medical Associates CurrentSince Jan 28, 2024 Accepting new patients
Jackson Clinic PA CurrentSince Nov 11, 2024 Accepting new patients
Jackson Clinic PA CurrentSince Nov 11, 2024 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Suzanne C Gullotta Family Past Accepting new patients
Prime Care Medical Center PC Family Past Accepting new patients

Locations

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

60 Physicians Dr
Jackson, TN 38305
Phone (731) 664-9928

619 Skyline Dr
Jackson, TN 38301
Phone (731) 424-3682

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

16615 Highway 104 N
Ste B
Lexington, TN 38351
Phone (731) 968-0660

270 E Court Ave
#B
Selmer, TN 38375
Phone 73164579322931

Interoperability endpoints

  • Direct secure messaging: stacyehopper@jcpa.allscriptsdirect.net

Organizations & group practices 6

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1710939301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-422-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013903",
            "telephone_number": "731-422-0213",
            "fax_number": "731-882-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "STACYE",
        "middle_name": "LEIGH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "100792",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "6005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.