Stacy A Wilson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71005227A Issued in IN

Practice address

328 N 2ND St Ste 307
Vincennes, IN 47591-1353

Phone

(812) 882-2703

Fax

(812) 882-2760

NPI assigned

Nov 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy A Johnson Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Hospital Physician Services, IncGroup PAC ID 3971671330, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swilson122201@direct.deaconess.com

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.

• Good Samaritan Hospital Physician Services, Inc

  • Hospitalist Physician
  • Vincennes, IN
  • NPI 1649432071
  Medicare reassignment Care Compare group NPD
• Advanced Gastroenterology, LLC

  • Gastroenterology Physician
  • Vincennes, IN
  • NPI 1083851042
  Medicare reassignment NPD
• Good Samaritan Hospital

  • Rural Health Clinic/Center
  • Vincennes, IN
  • NPI 1760145973
  NPD
• Good Samaritan Hospital Physician Services Inc.

  • Radiation Oncology Physician
  • Vincennes, IN
  • NPI 1629050646
  NPD (past)
• Good Samaritan Hospital Physician Services, Inc

  • Family Nurse Practitioner
  • Vincennes, IN
  • NPI 1780178467
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Vincennes, IN
  • NPI 1073153474

  Hospital

  Care Compare affiliation
• Good Samaritan Hospital

  • General Acute Care Hospital
  • Vincennes, IN
  • NPI 1225032881
  Care Compare affiliation

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1982000568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E SAINT CLAIR ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-885-3325",
            "fax_number": "812-885-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 N 2ND ST STE 307",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911353",
            "telephone_number": "812-882-2703",
            "fax_number": "812-882-2760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475911038",
            "country_code": "US",
            "telephone_number": "812-885-8770",
            "fax_number": "812-885-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STACY",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005227A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "JOHNSON",
            "middle_name": "A",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Lynn Williams, LCSW
• Wendy Lynette Williams, FNP-C
• William L Williams
• Dena Willis, PTA
• Willow Manor Investors Inc
• Joshua James Winchell, MD
• Courtnee Winemiller, RBT
• Martin Christopher James Winkler
• Daelyn Wood, BSN RN
• Kathrine Michelle Wright, LSW

• Family Nurse Practitioner in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.