Individual provider Active NPI

Stacey Marie Taylor, CRNP, MSN, FNP-C

  • Family Nurse Practitioner
  • Wilkes Barre, PA
National Provider Identifier
1861897456
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NOT AVAILABLE Issued in PA
Practice address
25 Church St
Wilkes Barre, PA 18765-0999
Phone
(570) 441-6262
NPI assigned
Oct 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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 NOT AVAILABLE PA Primary

Addresses

Primary practice location

25 Church St
Wilkes Barre, PA 18765-0999

Mailing address

1659 Fairview Ave
Berwick, PA 18603-2512
Phone (570) 441-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150504001420 PA Practitioner - Nurse Practitioner 8820317449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NOT AVAILABLEPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince May 4, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince May 4, 2015 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

25 Church St
Wilkes Barre, PA 18765
Phone (570) 826-3100

Interoperability endpoints

  • Direct secure messaging: stacey.taylor@direct.ghp.hie.keyhie.org
  • Direct secure messaging: staylor122967@direct.geisinger.edu

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": "1414281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1861897456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 FAIRVIEW AVE",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186032512",
            "telephone_number": "570-441-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187650999",
            "telephone_number": "570-441-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "CRNP, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-26",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "NOT AVAILABLE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.