Individual provider Active NPI

Nicole Leigh Stanley, NP

  • Family Nurse Practitioner
  • Henderson, TX
National Provider Identifier
1730732942
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1044608 Issued in TX
Practice address
300 Wilson St
Henderson, TX 75652-5956
Phone
(903) 655-6536
NPI assigned
Jul 17, 2019
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1044608 TX Primary

Addresses

Primary practice location

300 Wilson St
Henderson, TX 75652-5956

Mailing address

300 Wilson St
Henderson, TX 75652-5956
Phone (903) 655-6536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210803002041 TX Practitioner - Nurse Practitioner 1254735988 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jul 21, 2021 Accepting new patients
QV Urgent Care TX PLLC CurrentSince Aug 12, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jul 21, 2021 Accepting new patients
QV Urgent Care TX PLLC CurrentSince Aug 12, 2022 Accepting new patients
Henderson Memorial Hospital Past Accepting new patients
Starks Medical Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1600 US Highway 79 S
Henderson, TX 75654
Phone (903) 657-9571

300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536

Interoperability endpoints

  • Direct secure messaging: nstanley325238@ahs.direct-ci.com

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1730732942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-655-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-655-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "NICOLE",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1044608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

Verify at the official NPI Registry.