Stacey Brooke Cantor, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704279344 Issued in MI

Practice address

5150 Coolidge Hwy
Royal Oak, MI 48073-1001

Phone

(248) 655-3227

Fax

(248) 655-3237

NPI assigned

Sep 13, 2013

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Stacey Brooke Victor Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

University of Michigan Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Elizabeth Lake Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Waterford, MI
  • NPI 1538585260
  Medicare reassignment NPD
• Encore Geriatrics PLLC

  • General Practice Physician
  • Westland, MI
  • NPI 1053811380
  Medicare reassignment NPD
• Harper Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1992442560
  Medicare reassignment NPD
• Howell Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Howell, MI
  • NPI 1063124014
  Medicare reassignment NPD
• Lakeside Urgent Care, P. C.

  • Urgent Care Clinic/Center
  • Clinton Township, MI
  • NPI 1720159304
  Medicare reassignment NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment NPD
• Mound Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1063159630
  Medicare reassignment NPD
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  Medicare reassignment NPD
• Romeo Plank Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Macomb, MI
  • NPI 1184385791
  Medicare reassignment NPD
• Royal Urgent Care, PLLC

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1952833196
  Medicare reassignment NPD
• Shelby Urgent Care PC

  • Urgent Care Clinic/Center
  • Shelby TWP, MI
  • NPI 1326320599
  Medicare reassignment NPD
• Lakeside Urgent Care, P.C.

  • Internal Medicine Physician
  • Clinton Township, MI
  • NPI 1811226442
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1962837518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR",
            "address_2": "203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-655-3227",
            "fax_number": "248-655-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731001",
            "telephone_number": "248-655-3227",
            "fax_number": "248-655-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTOR",
        "first_name": "STACEY",
        "middle_name": "BROOKE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.14865-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704279344",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704279344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "VICTOR",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Michael Campbell, LLP
• Stephanie Campbell, M.D.
• Tricia Campbell, PA-C
• Cancer Care Associates PC
• Michael Cantley
• Christine Claire Cantrell, PH.D.
• Gonzalo Nathaniel Cantu Soriano, M.D.
• XI Cao, M.D.
• Cap Diagnostics LLC (Pathnostics)
• Julia Capeneka

• Family Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.