NPIMap

Individual provider Active NPI

Amiee Foley Stooksberry, APRN

  • Nurse Practitioner
  • Martin, TN
National Provider Identifier
1992919096
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12621 Issued in TN
Practice address
215 Hawks Rd
Suite 6
Martin, TN 38237-2708
Phone
(731) 587-3454
Fax
(731) 587-3460
NPI assigned
May 9, 2007
Last updated
Mar 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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 12621 TN Primary

Addresses

Primary practice location

215 Hawks Rd
Suite 6
Martin, TN 38237-2708

Mailing address

215 Hawks Rd
Suite 6
Martin, TN 38237-2708
Phone (731) 587-3454

Other identifiers 2

IdentifierTypeStateIssuer
4171303OtherTNBCBST
1516678MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071212000564 TN Practitioner - Nurse Practitioner 8426148602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin HealthGroup PAC ID 5193070613, 9 clinicians

Practice addresses (Care Compare)

143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12621TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Health Current Accepting new patients
Martin Health Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
Martin Hospital Company LLC Past Accepting new patients
Martin Health Past Accepting new patients
Surgical Specialists P C Past Accepting new patients

Locations

143 Kennedy Dr
Martin, TN 38237
Phone (731) 587-5321

1135 Broadway St
South Fulton, TN 38257
Phone (731) 479-2606

1135 Broadway St
Ste A
South Fulton, TN 38257
Phone (731) 479-2606

Interoperability endpoints

  • Direct secure messaging: astooksberry18757@directepic.wth.org

Organizations & group practices 5

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 6

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1992919096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HAWKS RD",
            "address_2": "SUITE 6",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382372708",
            "telephone_number": "731-587-3454",
            "fax_number": "731-587-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HAWKS RD",
            "address_2": "SUITE 6",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382372708",
            "telephone_number": "731-587-3454",
            "fax_number": "731-587-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOOKSBERRY",
        "first_name": "AMIEE",
        "middle_name": "FOLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4171303",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516678",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martin, TN

Sources for this page

Verify at the official NPI Registry.