Individual provider Active NPI

Stacy K. Mullet, NP

  • Nurse Practitioner
  • Huntersville, NC
National Provider Identifier
1922071570
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5001116 Issued in NC
Practice address
13220 Rosedale Hill Ave
Huntersville, NC 28078-0361
Phone
(704) 766-0320
Fax
(704) 766-0407
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5001116 NC Primary

Addresses

Primary practice location

13220 Rosedale Hill Ave
Huntersville, NC 28078-0361

Mailing address

13220 Rosedale Hill Ave
Huntersville, NC 28078-0361
Phone (704) 766-0320

Other names 1

  • Stacy K. Urban Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060128000044 NC Practitioner - Nurse Practitioner 3779597737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Medical Associates PLLCGroup PAC ID 6608836234, 2 clinicians

Practice addresses (Care Compare)

13220 Rosedale Hill Ave
Huntersville, NC 28078-0361
Phone (704) 766-0320

Hospital & facility affiliations

  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: smullet@progmednc.amazing-direct.com

Organizations & group practices 1

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 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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1922071570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13220 ROSEDALE HILL AVE",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280780361",
            "telephone_number": "704-766-0320",
            "fax_number": "704-766-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13220 ROSEDALE HILL AVE",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280780361",
            "telephone_number": "704-766-0320",
            "fax_number": "704-766-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLET",
        "first_name": "STACY",
        "middle_name": "K.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5001116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "URBAN",
            "middle_name": "K.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.