Stacy Beeson
Individual provider Active NPI Registered Dietitian · Nampa, ID
NPI 1811310360 · NPPES record last updated Oct 28, 2025
Key facts
- NPI
- 1811310360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1071188 (ID)
- Practice address
- 9850 W St Lukes Dr Ste 327
Nampa, ID 83687-7912 - Phone
- (208) 331-1155
- Fax
- (208) 383-0190
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic-Treasure Valley LLC
Practice addresses (Care Compare)
520 S Eagle Rd
Meridian, ID 83642-6355
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711
9850 St Lukes Dr
Nampa, ID 83687-7912
9850 W St Luke'S Dr
Nampa, ID 83687-7912
Hospital & facility affiliations
- St Luke'S Nampa Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.06 of 100
- Quality
- 89.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO, ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210225000039 | CO | Practitioner - Registered Dietitian Or Nutrition Professional | 6305251356 | Reassigns benefits to 2 organizations |
| I20251110002706 | ID | Practitioner - Registered Dietitian Or Nutrition Professional | 6305251356 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 810997 | CO | MD | Registered Dietitian |
| 1071188 | ID | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Health Initiatives Colorado | Current |
Accepting new patients | |
| Catholic Health Initiatives Colorado | Current |
Accepting new patients | |
| St Lukes Clinic-Treasure Valley LLC | Current |
Accepting new patients | |
| Nutrition Dynamix, LLC | Current |
Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193
825 Delaware Ave
Ste 200
Longmont, CO 80501
Phone (720) 252-9415
41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
9850 W St Lukes Dr
Ste 327
Nampa, ID 83687
Phone (208) 331-1155
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 810997 | CO | |
| Registered Dietitian | 133V00000X | 1071188 | ID | Yes |
Addresses
Primary practice location
9850 W St Lukes Dr Ste 327
Nampa, ID 83687-7912
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.