Active NPI
Stacie Crain
- Nurse Practitioner
- Carmichael, CA
National Provider Identifier
1750785002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 9500898
- Practice address
- 6501 Coyle Ave
Carmichael, CA 95608-0306 - Phone
- (916) 537-5079
- Fax
- (916) 966-3189
- NPI assigned
- Oct 15, 2014
- Last updated
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9500898 | CA | Primary |
Addresses
Primary practice location
6501 Coyle Ave
Carmichael, CA 95608-0306
Mailing address
3400 Data Dr
Physician Support Services
Rancho Cordova, CA 95670-7956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9500898 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413331200000",
"number": "1750785002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"address_2": "PHYSICIAN SUPPORT SERVICES",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 COYLE AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956080306",
"telephone_number": "916-537-5079",
"fax_number": "916-966-3189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIN",
"first_name": "STACIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-15",
"last_updated": "2014-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "9500898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
- County of Sacramento (CCS Starr King MTU)
- Dana Yvonne Cozzetto, D.P.M.
- William Scott Cragun, D.O.
- Craig N. Pfeiffer, M.D., Inc.
- Ronnie L Craig, MD
- Susan L Creighton-Clavel, LMFT
- Crestwood Behavioral Health, Inc. (American River Residential Services)
- Crestwood Behavioral Health, Inc. (American River Behavioral Health Center)
- Crestwood Behavioral Health, Inc. (Crestwood Psychiatric Health Facility)
- Matthew Crocker, LPCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.