Stacey Twigg

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0032697 Issued in OH

Practice address

4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551

Phone

(614) 580-6917

NPI assigned

Mar 27, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Stacey Smith Former name

Medicare fee-for-service enrollment

Enrolled in OH

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians

Concord Psychiatry, LLCGroup PAC ID 3577884105, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Concord Psychiatry, LLC

  • Psychiatry Physician
  • Dublin, OH
  • NPI 1134508260
  Medicare reassignment Care Compare group NPD
• Oh Independent Medical Group LLC

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1497482111
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1902301468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-580-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-580-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWIGG",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1450509",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "472924",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0032697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Qujuan Twilley, LISW
• Katelyn Twinem
• Dwight Tye
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• Patricia Marie Ufferman, L.I.S.W.

• Psychiatric/Mental Health Nurse Practitioner in Dublin, OH
• Providers in Dublin, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.