Individual provider Active NPI

Stacey Snyder Pannell, FNP

  • Family Nurse Practitioner
  • Canton, MS
National Provider Identifier
1831267756
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3001825 Issued in AL
Practice address
1668 West Peace Street
Canton, MS 39046
Phone
(601) 859-5213
Fax
(601) 859-8771
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R814593 MS
Family Nurse Practitioner 363LF0000X 3001825 AL Primary

Addresses

Primary practice location

1668 West Peace Street
Canton, MS 39046

Mailing address

422 Berkshire Dr
Ridgeland, MS 39157-3622

Other identifiers 1

IdentifierTypeStateIssuer
03309595MedicaidMS

Other names 1

  • Stacey Snyder Ingram Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070202000498 MS Practitioner - Nurse Practitioner 7113929282 Reassigns benefits to 3 organizations
I20241025000429 AL Practitioner - Nurse Practitioner 7113929282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alignmed Medical Group PCGroup PAC ID 3476090440, 62 clinicians

Practice addresses (Care Compare)

1350 14TH Ave SE
Decatur, AL 35601-4364
Phone (256) 355-6911

500 John Aldridge Dr
Tuscumbia, AL 35674-3000
Phone (256) 383-4541

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R814593MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alignmed Medical Group, PC CurrentSince Nov 13, 2024 Accepting new patients
Baptist Medical Center - Yazoo, Inc CurrentSince Feb 1, 2015 Accepting new patients
Signify Health, LLC CurrentSince Nov 1, 2023 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Sep 3, 2024 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Sep 3, 2024 Accepting new patients
Medical Foundation of Central Ms CurrentSince Dec 13, 2021 Accepting new patients
Alignmed Partners, PC CurrentSince Sep 3, 2024 Accepting new patients
Baptist Medical Center - Yazoo, Inc Current Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Dec 13, 2021 Accepting new patients
Trustcare Primary Care, LLC Past Accepting new patients

Locations

1350 14th Ave SE
Decatur, AL 35601
Phone (256) 355-6911

420 Dean Dr
Gardendale, AL 35071
Phone (205) 631-8700

500 John Aldridge Dr
Tuscumbia, AL 35674
Phone (256) 373-4541

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

460 Briarwood Dr
Ste 400
Jackson, MS 39206
Phone (601) 203-1016

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1831267756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 BERKSHIRE DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573622",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 WEST PEACE STREET",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "39046",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "STACEY",
        "middle_name": "SNYDER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R814593",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3001825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03309595",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "INGRAM",
            "middle_name": "SNYDER",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.