Individual provider Active NPI

Stacy Wilhelm

  • Acute Care Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1891275087
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP138206 Issued in TX
Practice address
3080 College St
Beaumont, TX 77701-4686
Phone
(409) 212-5000
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP138206 TX Primary

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4686

Mailing address

3080 College St
Beaumont, TX 77701-4606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200729003399 TX Practitioner - Nurse Practitioner 8426473026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Physician NetworkGroup PAC ID 0547333890, 121 clinicians

Practice addresses (Care Compare)

3080 College St
Beaumont, TX 77701-4606
Phone (409) 212-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Jun 15, 2020 Accepting new patients
Broussard Family Practice, PLLC Past Accepting new patients

Locations

810 Hospital Dr
Ste 100
Beaumont, TX 77701
Phone (409) 212-5933

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

Interoperability endpoints

  • Direct secure messaging: swilhelm@yourcarecommunity.org

Organizations & group practices 2

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": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1891275087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014686",
            "telephone_number": "409-212-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP138206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.