Mrs Stacy Johnson, MSN, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Kansas, Oklahoma. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Integrated Community Clinics Pa, Integrated Community Clinics Pa and her current practice location is
1261 E Tulsa Ave, Kansas, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 868-2175.
Mrs Stacy Johnson is licensed to practice in Oklahoma (license number M86384) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1548745334.
Provider's Profile
| Full Name | Mrs Stacy Johnson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 1261 E Tulsa Ave, Kansas, Oklahoma |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Stacy Johnson graduated from nursing school in 2018
NPI Data:
- NPI Number: 1548745334
- Provider Enumeration Date: 09/27/2018
- Last Update Date: 09/27/2018
Medicare PECOS Information:
- PECOS PAC ID: 0042554545
- Enrollment ID: I20181211001733
Medical Identifiers
Medical identifiers for Mrs Stacy Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1548745334 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | A005920 (Arkansas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | M86384 (Oklahoma) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Integrated Community Clinics Pa | 2567361165 | 21 |
| Integrated Community Clinics Pa | 2567361165 | 21 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Stacy Johnson allows following entities to bill medicare on her behalf.
| Entity Name | Integrated Community Clinics Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760440226
PECOS PAC ID: 2567361165
Enrollment ID: O20040616001145 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Stacy Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Stacy Johnson, MSN, APRN, FNP-C
1261 E Tulsa Ave,
Kansas, OK 74347-7026
Ph: () - | Mrs Stacy Johnson, MSN, APRN, FNP-C
1261 E Tulsa Ave,
Kansas, OK 74347-7026
Ph: (918) 868-2175 |
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