Individual provider Active NPI

Kathleen M Stagg, APRN

  • Family Nurse Practitioner
  • Safety Harbor, FL
National Provider Identifier
1922483189
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023429 Issued in FL
Practice address
1840 Mease Dr Ste 307
Safety Harbor, FL 34695-6605
Phone
(727) 725-6128
NPI assigned
Jul 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X L1-0045972 DE
Family Nurse Practitioner 363LF0000X APRN11023429 FL Primary

Addresses

Primary practice location

1840 Mease Dr Ste 307
Safety Harbor, FL 34695-6605

Mailing address

1840 Mease Dr Ste 307
Safety Harbor, FL 34695-6605
Phone (727) 725-6128

Other identifiers 1

IdentifierTypeStateIssuer
117033500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230317001797 FL Practitioner - Nurse Practitioner 3375917180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Respiratory Specialists LLCGroup PAC ID 9234156092, 16 clinicians

Practice addresses (Care Compare)

1840 Mease Dr
Suite 307
Safety Harbor, FL 34695-6605
Phone (727) 725-6128

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0045972DEMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Specialists LLC CurrentSince Feb 13, 2023 Accepting new patients

Locations

1399 Hamlet Ave
Clearwater, FL 33756
Phone (727) 441-4526

1840 Mease Dr
Ste 307
Safety Harbor, FL 34695
Phone (727) 725-6128

Networks

  • Freedom Health HMO Network

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 3

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1922483189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MEASE DR STE 307",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956605",
            "telephone_number": "727-725-6128",
            "fax_number": "727-725-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MEASE DR STE 307",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956605",
            "telephone_number": "727-725-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGG",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "DE",
            "license": "L1-0045972",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117033500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.