Jennifer Rae Stallings, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

39413 Issued in ID

Practice address

2120 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639

Phone

(208) 625-6944

Fax

(208) 625-6945

NPI assigned

Jun 22, 2021

Last updated

Sep 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Shoshone Medical Center Hospital, Kellogg, ID, CCN 131314

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/

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.

• North Idaho Wound Care PLLC

  • Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1932052529
  Medicare reassignment NPD Authorized official
• Clearwater Valley Hospital & Clinics Inc.

  dba Clearwater Valley Health

  • Rural Health Clinic/Center
  • Orofino, ID
  • NPI 1033153739
  NPD
• Clearwater Valley Hospital & Clinics Inc.

  dba Clearwater Valley Health

  • Family Medicine Physician
  • Orofino, ID
  • NPI 1073551396
  NPD
• Clearwater Valley Hospital & Clinics Inc.

  • Critical Access Hospital
  • Orofino, ID
  • NPI 1255449013
  NPD
• Kootenai Health, Inc.

  dba Kootenai Health Pharmacy

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD
• Kootenai Health, Inc.

  dba Kootenai Medical Center Oncology Group

  • Hematology & Oncology Physician
  • Coeur d'Alene, ID
  • NPI 1699807743
  NPD
• Shoshone Medical Center

  • Critical Access Hospital
  • Kellogg, ID
  • NPI 1043215437
  NPD
• St. Mary's Hospital Inc

  dba St. Mary's Health

  • Family Medicine Physician
  • Nezperce, ID
  • NPI 1366480394
  NPD
• St. Mary's Hospital Inc

  dba St. Mary's Grangeville Clinic

  • Family Medicine Physician
  • Grangeville, ID
  • NPI 1710203237
  NPD
• Clearwater Valley Hospital & Clinics Inc.

  dba Kooskia Medical Clinic

  • Family Medicine Physician
  • Orofino, ID
  • NPI 1891733747
  NPD (past)
• St. Mary's Hospital Inc

  dba St. Mary's Health

  • Family Medicine Physician
  • Cottonwood, ID
  • NPI 1174577100
  NPD (past)

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• Shoshone Medical Center

  • Critical Access Hospital
  • Kellogg, ID
  • NPI 1043215437
  Care Compare affiliation

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1780253989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-6944",
            "fax_number": "208-625-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-625-6944",
            "fax_number": "208-625-6945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Jacobs Gulch Rd",
            "address_purpose": "LOCATION",
            "city": "Kellogg",
            "state": "ID",
            "postal_code": "838372023",
            "country_code": "US",
            "telephone_number": "208-784-1221",
            "fax_number": "208-784-0961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11120 NE 33rd Pl Ste 202",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980041444",
            "country_code": "US",
            "telephone_number": "206-823-1004",
            "fax_number": "206-309-3319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "39413",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "67570",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wolfgang J.T. Spyra, MD
• Stability Mental Health, PLLC
• Emily Lee Stadstad, MA, LMFT
• Douglas R Stafford, M.D.
• Ione Ellowene Stafford, LMT
• Leslie Stangeland, LMSW
• Tyler Stanley
• Christine Lee Stanton, M.S., CCC - SLP
• Gary Louis Stanton, PHD
• Carolyn Staples, M.S. CCC-SLP

• Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.