Individual provider Active NPI

Stacy Ann Pryor, FNP-BC

  • Family Nurse Practitioner
  • Miami, OK
National Provider Identifier
1760350615
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
225971 Issued in OK
Practice address
61791 E 96 Rd
Miami, OK 74354-3856
Phone
(918) 541-4036
NPI assigned
Oct 23, 2025
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 225971 OK Primary

Addresses

Primary practice location

61791 E 96 Rd
Miami, OK 74354-3856

Mailing address

61791 E 96 Rd
Miami, OK 74354-3856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260225000165 TX Practitioner - Nurse Practitioner 3870074123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Tribal Health SystemGroup PAC ID 7911893854, 20 clinicians

Practice addresses (Care Compare)

7600 S Hwy 69a
Miami, OK 74354-1016
Phone (918) 542-1655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
225971OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Tribal Health System CurrentSince Jan 29, 2026 Accepting new patients

Locations

7600 S Highway 69A
Miami, OK 74354
Phone (918) 542-1655

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1760350615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61791 E 96 RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743543856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61791 E 96 RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743543856",
            "telephone_number": "918-541-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "225971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.