Stacy Leann Fiske, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2023030046 Issued in MO

Practice address

17959 Main Street
Eminence, MO 65466

Phone

(573) 226-5505

NPI assigned

Aug 2, 2023

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

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

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.

• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321

  MO

  Medicare reassignment NPD
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  MO, Nurse Practitioner

  Medicare reassignment NPD
• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Annapolis, MO
  • NPI 1225131501
  NPD
• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1760164412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20067 BEARCLAW RD",
            "city": "EUNICE",
            "state": "MO",
            "postal_code": "654686804",
            "telephone_number": "417-247-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17959 MAIN STREET",
            "city": "EMINENCE",
            "state": "MO",
            "postal_code": "65466",
            "telephone_number": "573-226-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISKE",
        "first_name": "STACY",
        "middle_name": "LEANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023030046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Big Springs Medical Association
• Joseph Chester Francis Camire, D.O.
• Dale Family Medicine
• Eminence R-1 School District
• Sherry K Foster
• Jaime Hampton, CPNP-PC, FNP-C
• Dale E. Haverstick, MD
• Dianna Lavee Keeling, FNP
• Lacey Ann Skelton

• All providers in Eminence, MO
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.