Mary J Stackle, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP-945A Issued in ID

Practice address

8050 W Northview St
Boise, ID 83704-7126

Phone

(208) 327-0504

NPI assigned

Feb 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Behavioral Health ServicesGroup PAC ID 5991860413, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Access Behavioral Health Services

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1487700589
  Medicare reassignment Care Compare group NPD
• Access Behavioral Health Services, Inc

  • Primary Care Clinic/Center
  • Boise, ID
  • NPI 1932506508
  NPD

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1841522661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 W NORTHVIEW ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047126",
            "telephone_number": "208-327-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 W NORTHVIEW ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047126",
            "telephone_number": "208-327-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKLE",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "NP-945A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stability Mental Health, PLLC (SMH Academy)
• Debra Jean Stace, LMSW
• Julie Lynn Stace, CSFA
• Stacey Titus PLLC (Clearwater Counseling Services)
• Eric Gerand Stackle, MD
• Daniel John Stackowicz, DDS
• Stacy J. Moon DDS, PA
• Mardi Stacy, PH.D.
• Stephanie Elizabeth Stacy
• Heather Ann Stafford, NP-C

• Psychiatric/Mental Health Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.