Individual provider Active NPI

Stacy Lynn Young, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Ormond Beach, FL
National Provider Identifier
1942682984
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024636 Issued in FL
Practice address
901 Sterthaus Dr
Ormond Beach, FL 32174-5133
Phone
(573) 552-6866
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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 APRN11024636 FL Primary
Family Nurse Practitioner 363LF0000X 2015016930 MO

Addresses

Primary practice location

901 Sterthaus Dr
Ormond Beach, FL 32174-5133

Mailing address

25 Canterbury Woods
Ormond Beach, FL 32174-2449
Phone (573) 552-6866

Other practice location 1

1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150730013098 MO Practitioner - Nurse Practitioner 1254645567 Reassigns benefits to 1 organization
I20230524003658 FL Practitioner - Nurse Practitioner 1254645567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Healthcare Partners, Inc CurrentSince Jul 3, 2023 Accepting new patients
Camden Emergency Group LLC CurrentSince Mar 6, 2018 Accepting new patients

Locations

301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

901 Sterthaus Dr
Ormond Beach, FL 32174
Phone (386) 206-5908

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: syoung1712103@adventhealth.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1942682984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CANTERBURY WOODS",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742449",
            "telephone_number": "573-552-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 STERTHAUS DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745133",
            "telephone_number": "573-552-6866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Nichols Rd",
            "address_purpose": "LOCATION",
            "city": "Osage Beach",
            "state": "MO",
            "postal_code": "650653093",
            "country_code": "US",
            "telephone_number": "573-302-3999",
            "fax_number": "573-302-2751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024636",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015016930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.