Stacie Lynne Ebersold, MSN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP020581 Issued in PA

Practice address

100 S Juniper St FL 3
Philadelphia, PA 19107-1316

Phone

(866) 849-0692

NPI assigned

Jul 5, 2019

Last updated

May 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, FL2 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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suburban Geriatric's, Inc.Group PAC ID 4486551371, 102 clinicians

Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Suburban Geriatrics II PC

  • Internal Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1073273363
  Medicare reassignment Care Compare group NPD
• Suburban Geriatrics, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Plymouth Meeting, PA
  • NPI 1679594808
  Medicare reassignment Care Compare group NPD
• Violet Valley Long Term Care PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Plymouth Meeting, PA
  • NPI 1649164617
  Medicare reassignment NPD
• Wellspan Medical Group

  dba WellSpan Digestive Health

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment NPD
• Devoted Medical Group Professional Corporation

  • Primary Care Clinic/Center
  • Pembroke Pines, FL
  • NPI 1245838168
  Medicare reassignment NPD
• Wellspan Medical Group

  dba WellSpan Pediatric Surgical Specialist

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  dba WellSpan Urgent Care

  • Urgent Care Clinic/Center
  • Shippensburg, PA
  • NPI 1922704451
  NPD

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1750943155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JUNIPER ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071316",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Blair Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Horsham",
            "state": "PA",
            "postal_code": "190442223",
            "country_code": "US",
            "telephone_number": "717-577-9592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERSOLD",
        "first_name": "STACIE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11041685",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020581",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "41288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Ruthanne Eberhart, MS, CCC-SLP
• Jaime Eberle-Singh, MD, PHD
• Loretta Ellen Eberle, LPC
• Allison Elizabeth Eberly, CRNP
• Lauren Anne Eberly, M.D.
• Barbara Ebersole, BFA, MA, CCC-SLP
• Joseph K. Ebert, CRNA
• Ebh Eye Associates, PLLC
• Mackenzie Amor Ebinger
• Stephanie Kathryn Eble

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.