Stacey M Greenup, PPCNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN86910-PPCNP-BC Issued in WV

Practice address

700 Childrens Dr
Nationwide Children'S Hospital-Cticu
Columbus, OH 43205-2664

Phone

(614) 722-9042

NPI assigned

Jan 30, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  NPD (past)
• River Valley Medicine and Pediatrics Inc.

  • Internal Medicine Physician
  • Parkersburg, WV
  • NPI 1225095995
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1750653291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 GARFIELD AVE",
            "address_2": "SUITE B",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261012527",
            "telephone_number": "304-893-9090",
            "fax_number": "304-893-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "address_2": "NATIONWIDE CHILDREN'S HOSPITAL-CTICU",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENUP",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "PPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-30",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "2011009651",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "APRN86910-PPCNP-BC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810028858",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Lynn Greenlee
• Rachel Helen Greenlee, SPTA
• Tyler Edward Greenlee, DO
• Greenshield Health Services, LLC
• Katarina Greenslade, QMHS
• Julie Greenwald, R.D., L.D.
• Matthew Greenwald, DO
• Shay Greenwalt
• Alyssa Marie Greenwell, DO
• Dana Kristine Greenwell, MOTR/L

• Pediatric Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.