Active NPI
Jacqueline Marie Stoll, NP
- Psychiatric/Mental Health Nurse Practitioner
- Wasilla, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 9406716
- Practice address
- 1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083 - Phone
- (907) 729-3300
- Fax
- (907) 729-8607
- NPI assigned
- Oct 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R41453 | NM | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 9406716 | FL | Primary |
Addresses
Primary practice location
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Mailing address
7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-6351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.4 of 100
- Quality
- 72.78
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 76.77
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9406716 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| TBJ Behavioral Center LLC | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Bluesky Telepsych | Past | Accepting new patients | |
| Cherokee Nation | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
Locations
4441 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-2000
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000
6300 Beach Blvd
Jacksonville, FL 32216
Phone (904) 724-9202
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
Organizations & group practices 9
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.
-
- Psychiatric Hospital
- Jacksonville, FL
- NPI 1568633683
-
- Public Health or Welfare Agency
- Tahlequah, OK
- NPI 1013884154
-
- Multi-Specialty Clinic/Center
- Muskogee, OK
- NPI 1841207156
-
- Multi-Specialty Clinic/Center
- Ochelata, OK
- NPI 1871972430
-
- Multi-Specialty Clinic/Center
- Wasilla, AK
- NPI 1386680056
-
- Psychiatry Physician
- Chicago, IL
- NPI 1659996767
-
- General Acute Care Hospital
- Tahlequah, OK
- NPI 1275799645
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tahlequah, OK
- NPI 1275799645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1770735136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7033 E TUDOR RD",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995071262",
"telephone_number": "907-729-6351",
"fax_number": "907-729-8607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S KNIK GOOSE BAY RD",
"city": "WASILLA",
"state": "AK",
"postal_code": "996548083",
"telephone_number": "907-729-3300",
"fax_number": "907-729-8607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLL",
"first_name": "JACQUELINE",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-16",
"last_updated": "2022-06-08",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NM",
"license": "R41453",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "9406716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.