NPIMap

Individual provider Active NPI

Stacy Utton

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1912351404
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173588 Issued in VA
Practice address
1101 First Colonial Rd
Ste. 300
Virginia Beach, VA 23454-2409
Phone
(757) 481-4817
NPI assigned
Apr 20, 2016
Last updated
Jun 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173588 VA Primary
Gastroenterology Registered Nurse 163WG0100X 0001181340 VA

Addresses

Primary practice location

1101 First Colonial Rd
Ste. 300
Virginia Beach, VA 23454-2409

Mailing address

5160 Amberly Rd
Virginia Beach, VA 23462-3629
Phone (757) 687-8485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160818001234 VA Practitioner - Nurse Practitioner 9032404876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Digestive Care LLCGroup PAC ID 3870669419, 241 clinicians

Practice addresses (Care Compare)

1717 Will O Wisp Dr
Suite 200
Virginia Beach, VA 23454-3102
Phone (757) 481-4817

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001181340VAMDGastroenterology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Digestive Care, LLC CurrentSince Aug 1, 2022 Accepting new patients
Gastrointestinal and Liver Specialists of Tidewater PLLC CurrentSince Oct 27, 2019 Accepting new patients
Capital Digestive Care, LLC CurrentSince Aug 1, 2022 Accepting new patients
Capital Digestive Care ,LLC Current Accepting new patients
Capital Digestive Care ,LLC Past Accepting new patients

Locations

113 Gainsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 436-3285

1101 First Colonial Rd
Ste 300
Virginia Beach, VA 23454
Phone (757) 395-1760

1101 First Colonial Rd
Ste 400
Virginia Beach, VA 23454
Phone (757) 481-4817

1717 Will O Wisp Dr
Ste 200
Virginia Beach, VA 23454
Phone (757) 481-4817

1925 Glenn Mitchell Dr
Ste 102
Virginia Beach, VA 23456
Phone (757) 464-1644

828 Healthy Way
Ste 210
Virginia Beach, VA 23462
Phone (757) 481-4817

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1912351404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 AMBERLY RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623629",
            "telephone_number": "757-687-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD",
            "address_2": "STE. 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTON",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173588",
            "primary": true
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "VA",
            "license": "0001181340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.