Stacy Adair Woodard

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5939 Issued in MN

Practice address

6469 Sycamore CT N
Maple Grove, MN 55369-6028

Phone

(763) 276-9443

NPI assigned

Jul 2, 2018

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 MN, ND, IA3 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 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifeway Health and Wellness LLCGroup PAC ID 4486004405, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lifeway Health & Wellness LLC

  • Primary Care Clinic/Center
  • Maple Grove, MN
  • NPI 1598443723
  Medicare reassignment Care Compare group NPD Authorized official
• Rvision Health of Iowa P.C.

  • Primary Care Clinic/Center
  • Webster City, IA
  • NPI 1740984418
  Medicare reassignment NPD
• Rvision Health of North Dakota PC

  • Primary Care Clinic/Center
  • Fargo, ND
  • NPI 1033845243
  Medicare reassignment NPD

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1740776707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6469 SYCAMORE CT N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696028",
            "telephone_number": "763-276-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6469 SYCAMORE CT N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696028",
            "telephone_number": "763-276-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "STACY",
        "middle_name": "ADAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Wolters
• Ashley Wong, AU.D.
• Fu Wong, DDS
• Jonathan Gee Hin Wong
• Nathan Gee Yut Wong, DDS
• Barbara Wormington
• Angel Wright
• Susan Mentjes Wrobel, NP
• Lucas Walker Wyatt, LPCC
• Jade Wynn

• Family Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.