Individual provider Active NPI

Stacey Hayward, NP

  • Nurse Practitioner
  • Palmer, AK
National Provider Identifier
1942236054
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
281 Issued in AZ
Practice address
2490 S Woodworth Loop
Palmer, AK 99645-7410
Phone
(907) 861-6315
Fax
(907) 861-6315
NPI assigned
Jun 23, 2006
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 281 AZ Primary

Addresses

Primary practice location

2490 S Woodworth Loop
Palmer, AK 99645-7410

Mailing address

PO Box 27340
Phoenix, AZ 85061-7340
Phone (602) 943-9200

Other identifiers 1

IdentifierTypeStateIssuer
589880MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20250610002980 AK Practitioner - Nurse Practitioner 0143240382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alaska Gi Associates LLCGroup PAC ID 8426543323, 6 clinicians

Practice addresses (Care Compare)

3190 E Meridian Park Loop
Suite 206
Wasilla, AK 99654-7422
Phone (907) 373-2544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0281AZMDAcupuncturist
281AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mat-Su Valley III LLC Current Accepting new patients
Alaska Gi Associates LLC CurrentSince Dec 2, 2025 Accepting new patients

Locations

2490 S Woodworth Loop
Ste 200
Palmer, AK 99645
Phone (907) 746-7747

3190 E Meridian Park Loop
Ste 206
Wasilla, AK 99654
Phone (907) 373-2544

950 E Bogard Rd
Ste 207
Wasilla, AK 99654
Phone (907) 357-9444

Interoperability endpoints

  • Direct secure messaging: stacey.hayward.1@2839.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1942236054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850617340",
            "telephone_number": "602-943-9200",
            "fax_number": "602-216-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457410",
            "telephone_number": "907-861-6315",
            "fax_number": "907-861-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "STACEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589880",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

Verify at the official NPI Registry.