Individual provider Active NPI

Stacey Lynn Wilson, ARNP

  • Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1730582701
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9310438 Issued in FL
Practice address
1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone
(561) 366-4100
Fax
(866) 326-5063
NPI assigned
Oct 3, 2014
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 114128-23 NH
Nurse Practitioner 363L00000X APRN9310438 FL Primary
Adult Health Nurse Practitioner 363LA2200X ARNP9310438 FL

Addresses

Primary practice location

1309 N Flagler Dr
West Palm Beach, FL 33401-3406

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000

Other identifiers 1

IdentifierTypeStateIssuer
110728200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, FL, VT, NH, WY5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20141205001965 OK Practitioner - Nurse Practitioner 5799007514
I20180219002353 FL Practitioner - Nurse Practitioner 5799007514 Reassigns benefits to 1 organization
I20240920002387 VT Practitioner - Nurse Practitioner 5799007514 Reassigns benefits to 1 organization
I20250624001048 NH Practitioner - Nurse Practitioner 5799007514 Reassigns benefits to 2 organizations
I20260608001933 WY Practitioner - Nurse Practitioner 5799007514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9310438FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 17, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 17, 2025 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Aug 16, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 17, 2025 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Jan 2, 2018 Accepting new patients

Locations

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

1309 N Flagler Dr
Fl Cancer
West Palm Beach, FL 33401

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Interoperability endpoints

  • Direct secure messaging: ms_swils303@landmarkhealth-direct.org
  • Direct secure messaging: swilson587376@direct.uvmhealth.org

Organizations & group practices 7

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 10

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1730582701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013406",
            "telephone_number": "561-366-4100",
            "fax_number": "866-326-5063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "fax_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "114128-23",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9310438",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9310438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110728200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.