Individual provider Active NPI

Stephanie Slack Allen, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Paris, TN
National Provider Identifier
1851848683
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
21694 Issued in TN
Practice address
408 Virginia St
Paris, TN 38242-5341
Phone
(731) 642-0521
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 21694 TN Primary

Addresses

Primary practice location

408 Virginia St
Paris, TN 38242-5341

Mailing address

101 Alberta St
Martin, TN 38237-3501
Phone (731) 514-5774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20181227002459 TN Practitioner - Nurse Practitioner 5395080071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

631 RB Wilson Dr
Huntingdon, TN 38344-1727
Phone (731) 986-4481

641 RB Wilson Dr
Huntingdon, TN 38344-1733
Phone (731) 986-4461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21694TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital-Huntingdon CurrentSince Aug 15, 2018 Accepting new patients
Baptist Memorial Hospital-Huntingdon CurrentSince Aug 15, 2018 Accepting new patients
Baptist Memorial Hospital-Huntingdon Current Accepting new patients
Carey Counseling Center, Inc. PastSince Jul 1, 2015 Accepting new patients

Locations

631 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-2933

641 Rb Wilson Dr
Ste G
Huntingdon, TN 38344
Phone (731) 986-7400

641 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-4461

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/careycounselingcenter/r4/
  • Direct secure messaging: sslackallen183262@direct.bmhcc.org

Organizations & group practices 4

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1851848683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ALBERTA ST",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373501",
            "telephone_number": "731-514-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 VIRGINIA ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382425341",
            "telephone_number": "731-642-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK ALLEN",
        "first_name": "STEPHANIE",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "21694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

Verify at the official NPI Registry.