Individual provider Active NPI

Autumn H Stucker, APRN

  • Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1760253173
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11030606 Issued in FL
Practice address
6606 Stadium Dr Ste a
Zephyrhills, FL 33542-7510
Phone
(813) 788-5575
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11030606 FL
Nurse Practitioner 363L00000X APRN11030606 FL Primary

Addresses

Primary practice location

6606 Stadium Dr Ste a
Zephyrhills, FL 33542-7510

Mailing address

38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240302000202 FL Practitioner - Nurse Practitioner 5496190258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

6606 Stadium Dr
Zephyrhills, FL 33542-7510
Phone (813) 788-5575

Hospital & facility affiliations

  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046
  • Adventhealth Dade City Hospital, Dade City, FL, CCN 100211
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11030606FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Apr 22, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Apr 22, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Ohi West Medical Group II LLC PastSince Jan 21, 2024 Accepting new patients

Locations

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

6606 Stadium Dr
Zephyrhills, FL 33542
Phone (813) 788-5575

6606 Stadium Dr
Ste A
Zephyrhills, FL 33542
Phone (813) 788-5575

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1760253173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 STADIUM DR STE A",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427510",
            "telephone_number": "813-788-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKER",
        "first_name": "AUTUMN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11030606",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11030606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.