Vista Blue Health and Wellness

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

VISTA BLUE HEALTH AND WELLNESS

Practice address

6545 Market Ave N Ste 100
Canton, OH 44721-2430

Phone

(216) 910-7450

Fax

(800) 324-1856

NPI assigned

Mar 11, 2024

Last updated

Aug 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Stephany C. Hasberry, APRNNPI 1235747700

Title

Practitioner/Owner/Partner

Phone

(216) 910-7450

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephany Cecile Hasberry, MSN; APRN: FNP-BC

  • Family Nurse Practitioner
  • Mentor, OH
  • NPI 1235747700
  Medicare reassignment NPD Authorized official
• Michael A. Adams, CNP

  • Gerontology Nurse Practitioner
  • University Heights, OH
  • NPI 1659983252
  Medicare reassignment NPD
• Ebony Dominaque Carter, NP-C

  • Gerontology Nurse Practitioner
  • Shaker Heights, OH
  • NPI 1770905226

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1821856394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 MARKET AVE N STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212430",
            "telephone_number": "216-910-7450",
            "fax_number": "800-324-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 MARKET AVE N STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212430",
            "telephone_number": "216-910-7450",
            "fax_number": "800-324-1856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27651 Lake Shore Blvd",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441321356",
            "country_code": "US",
            "telephone_number": "216-973-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISTA BLUE HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "HASBERRY",
        "authorized_official_first_name": "STEPHANY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRACTITIONER/OWNER/PARTNER",
        "authorized_official_telephone_number": "216-910-7450",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235747700",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659983252",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770905226",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://wc-wfe-127.advancedmd.com/WebClinical/TopPage.aspx?loginapp=1&ehr=1",
            "affiliation": "N",
            "endpointDescription": "Advanced MD charting system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6545 Market Ave N Ste 100",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447212430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Kay Violet
• Niko Sebastiano Virola
• Vishnu Sai LLC
• Visionworks, Inc. (Visionworks)
• Melissa S Visnick, LPN
• Vista Psychological & Counseling Centre LLC
• Wendy Lynn Vitagliano
• Rebecca Vitale
• Vitality Med LLC (Vitality Med)
• Vitality Physical Therapy LLC

• Primary Care Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Primary Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.