Stacy Lea Dwyer, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

102223 Issued in OK

Practice address

4140 W Memorial Rd Ste 215
Oklahoma City, OK 73120-8361

Phone

(405) 242-4030

Fax

(405) 242-4031

NPI assigned

Dec 31, 2018

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdwyer168521@directc.mercy.net

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment NPD

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1730651779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 215",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208361",
            "telephone_number": "405-242-4030",
            "fax_number": "405-242-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 215",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208361",
            "telephone_number": "405-242-4030",
            "fax_number": "405-242-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "STACY",
        "middle_name": "LEA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-31",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "102223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dva Healthcare Renal Care Inc (Oklahoma City South Dialysis)
• Dva Renal Healthcare Inc (Lexington OK Prison)
• Dva Renal Healthcare Inc (Heartland Dialysis)
• Alex Agyei Dwuma, MD
• Harlee Nicole Dwyer, MD
• D. Scott Dycus, D.O.
• William Dycus, PH.D.
• Bradley Victor Dye, MD
• Drew Lawrence Dye, D.O.
• Christine N. Dyer, PHARMD

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.