NPIMap

Individual provider Active NPI

Stacey N Mills, C-FNP

  • Family Nurse Practitioner
  • Elizabeth, WV
National Provider Identifier
1740611920
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78599 Issued in WV
Practice address
483 Court Street
Elizabeth, WV 26143-0609
Phone
(304) 275-3301
Fax
(304) 275-4798
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 78599 WV Primary

Addresses

Primary practice location

483 Court Street
Elizabeth, WV 26143-0609

Mailing address

PO Box 609
Elizabeth, WV 26143-0609
Phone (304) 275-3301

Other identifiers 1

IdentifierTypeStateIssuer
78599OtherWVLICENSE

Other names 1

  • Stacey N Valentine Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150114002466 WV Practitioner - Nurse Practitioner 1658695960 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wirt County Health Services Association, Inc Current Accepting new patients
Wirt County Health Services Association, Inc CurrentSince Sep 20, 2014 Accepting new patients
Wirt County Health Services Association Inc Current Accepting new patients
Wirt County Health Services Association Inc CurrentSince Sep 20, 2014 Accepting new patients

Locations

483 Court St
Elizabeth, WV 26143
Phone (304) 275-3301

606 Washington St
Ravenswood, WV 26164
Phone (304) 273-1033

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wirt County Health Services Association, Inc 31 clinicians

Practice addresses (Care Compare)

PO Box
Suite 609
Elizabeth, WV 26143

Hospital & facility affiliations

  • Minnie Hamilton Health System Hospital, Grantsville, WV, CCN 511303
  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1740611920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261430609",
            "telephone_number": "304-275-3301",
            "fax_number": "304-275-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 COURT STREET",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261430609",
            "telephone_number": "304-275-3301",
            "fax_number": "304-275-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "STACEY",
        "middle_name": "N",
        "credential": "C-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "78599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "78599",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "VALENTINE",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elizabeth, WV

Sources for this page

Verify at the official NPI Registry.