Active NPI
Stacy Ann Kennedy, A.P.N.
- Adult Health Nurse Practitioner
- Mountain Home, AR
National Provider Identifier
1720052616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- A003832
- Practice address
- 3 Medical PLZ
Mountain Home, AR 72653-2918 - Phone
- (870) 424-3400
- Fax
- (870) 424-4121
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | A003832 | AR | Primary |
Addresses
Primary practice location
3 Medical PLZ
Mountain Home, AR 72653-2918
Mailing address
3 Medical PLZ
Mountain Home, AR 72653-2918
Phone (870) 424-3400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SV086 | Other | AR | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1720052616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MEDICAL PLZ",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726532918",
"telephone_number": "870-424-3400",
"fax_number": "870-424-4121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MEDICAL PLZ",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726532918",
"telephone_number": "870-424-3400",
"fax_number": "870-424-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "STACY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "A.P.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "AR",
"license": "A003832",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "SV086",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.