Stacy Ellis, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

176698 Issued in TN

Practice address

8060 Wolf River Blvd
Germantown, TN 38138-1727

Phone

(901) 271-1000

Fax

(901) 271-4187

NPI assigned

Apr 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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 2

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.

• Stern Cardiovascular Center, PA

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1699790311

  MS

  Medicare reassignment NPD
• Stern Cardiovascular Foundation, Inc

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1316242266

  MS

  Medicare reassignment

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1750608287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000",
            "fax_number": "901-271-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000",
            "fax_number": "901-271-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "STACY",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R884850",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "176698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN APN",
            "identifier": "17698",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yasmeen Elaskary
• Elite Dental Germantown PLC
• Claire C Ellender, PAC
• Kathryn Ellis
• Richard Alan Ellis, M.D.
• Adam Christopher Elnaggar, MD
• Julianna Michelle Elsea, PA-C
• Amanda Michele Embry, LPC-MHSP
• Donald S Emerson, MD
• Endocrinology and Diabetes Specialists, LLC

• Family Nurse Practitioner in Germantown, TN
• Providers in Germantown, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.