Stacey Ogletree Lynch, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

A005293 Issued in AR

Practice address

1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356

Phone

(870) 243-0424

Fax

(534) 248-4225

NPI assigned

Feb 13, 2014

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

Other names 1

• Stacey Danielle Ogletree Former name

Medicare fee-for-service enrollment

Enrolled in MS, AR2 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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Mental Health and Wellness LLCGroup PAC ID 0345574737, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Renew Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
  • NPI 1447817572
  Medicare reassignment Care Compare group Authorized official
• Arkansas Psychiatric Clinic Clinical Research Trials, PA

  • Psychiatry Physician
  • Little Rock, AR
  • NPI 1548661200
  Medicare reassignment NPD
• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment NPD
• Region Ten Commission State of Ms

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, MS
  • NPI 1073626511
  Medicare reassignment NPD
• Renew Mental Health and Wellness, LLC

  • Specialist
  • Jonesboro, AR
  • NPI 1467134007
  NPD Authorized official
• Hinds County Mental Health Comission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MS
  • NPI 1205853652
  Medicare reassignment
• Medical Foundation of Central Ms

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• Renew Mental Health and Wellness, LLC

  • Clinical Social Worker
  • Jonesboro, AR
  • NPI 1720802341
  NPD (past)

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1750705513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424",
            "fax_number": "534-248-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424",
            "fax_number": "534-248-4225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 Grayhawk Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391104004",
            "country_code": "US",
            "telephone_number": "601-624-9454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "149 Grayhawk Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391104004",
            "country_code": "US",
            "telephone_number": "601-624-9454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "STACEY",
        "middle_name": "OGLETREE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A005293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "OGLETREE",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riley Ann Luttrell, M.S., CF-SLP
• Lux Vein & Body PLLC
• Gregory Logan Lynch, M.D.
• John Kevin Lynch, D.O.
• Kristy Lynch
• Rhonda Lynk Lynk-Pearson, LPC
• Christopher Lynn
• Jenna Lynn
• Phillip Alexander Lynn
• Jennifer Ann Lyons

• Psychiatric/Mental Health Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.