Active NPI
Mandy Elaine Stuckey
- Nursing Home Administrator
- Sedalia, MO
National Provider Identifier
1922285386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 035165
- Practice address
- 419 N Prospect Ave
Sedalia, MO 65301 - Phone
- (660) 826-5353
- Fax
- (660) 826-5780
- NPI assigned
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 035165 | MO | Primary |
Addresses
Primary practice location
419 N Prospect Ave
Sedalia, MO 65301
Mailing address
419 N Prospect Ave
Sedalia, MO 65301
Phone (660) 826-5353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035165 | MO | MD | Nursing Home Administrator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunny Meadows Living Center | Past | Accepting new patients |
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Sedalia, MO
- NPI 1235308602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1922285386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 N PROSPECT AVE",
"city": "SEDALIA",
"state": "MO",
"postal_code": "65301",
"telephone_number": "660-826-5353",
"fax_number": "660-826-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 N PROSPECT AVE",
"city": "SEDALIA",
"state": "MO",
"postal_code": "65301",
"telephone_number": "660-826-5353",
"fax_number": "660-826-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUCKEY",
"first_name": "MANDY",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-29",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "MO",
"license": "035165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.