Individual provider Active NPI

Kirby Elizabeth Stacks, NP-C

  • Family Nurse Practitioner
  • Seymour, IN
National Provider Identifier
1841606951
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004977A Issued in IN
Practice address
411 W Tipton St
Seymour, IN 47274-2363
Phone
(812) 523-5862
Fax
(812) 523-4753
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004977A IN Primary

Addresses

Primary practice location

411 W Tipton St
Seymour, IN 47274-2363

Mailing address

411 W Tipton St
Seymour, IN 47274-2363
Phone (812) 523-5862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20140818002488 IN Practitioner - Nurse Practitioner 8426275249 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson County Schneck Memorial HospitalGroup PAC ID 8224004585, 139 clinicians

Practice addresses (Care Compare)

200 S Walnut St
Schneck Medical Center
Seymour, IN 47274-2312
Phone (812) 522-2349

411 W Tipton St
Seymour, IN 47274-2363
Phone (812) 522-2349

Hospital & facility affiliations

  • Schneck Medical Center Hospital, Seymour, IN, CCN 150065

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71004977AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Emergency Professionals PC Nurse Practitioner CurrentSince Jun 15, 2016 Accepting new patients
Inphynet Primary Care Physicians Midwest, S.C. Nurse Practitioner CurrentSince Nov 1, 2018 Accepting new patients
Jackson County Schneck Memorial Hospital Nurse Practitioner CurrentSince Nov 1, 2014 Accepting new patients
Jackson County Schneck Memorial Hospital PastSince Mar 1, 2021 Accepting new patients
Seymour Indiana Pathologists, Inc Past Accepting new patients

Locations

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

806 W Commerce St
Brownstown, IN 47220
Phone (812) 358-2400

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

1001 N Grant St
Lebanon, IN 46052
Phone (765) 482-6400

1124 Medical Pl
Seymour, IN 47274
Phone (812) 519-1552

411 W Tipton St
Ste 4
Seymour, IN 47274

200 S Walnut St
Seymour, IN 47274
Phone (812) 522-2349

411 W Tipton St
Fl 4
Seymour, IN 47274
Phone (812) 523-5862

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

1130 Medical Pl
Seymour, IN 47274
Phone (812) 519-1552

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1841606951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-523-5862",
            "fax_number": "812-523-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-523-5862",
            "fax_number": "812-523-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKS",
        "first_name": "KIRBY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004977A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

Verify at the official NPI Registry.