Stacy M Pemberton, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Sequatchie, Tennessee. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Knoxville Center For Behavioral Medicine Llc, Volunteer Behavioral Health Care System and her current practice location is
298 Sequatchie Mountain Rd, Sequatchie, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 605-7415.
Stacy M Pemberton is licensed to practice in Tennessee (license number 36877) 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 1063241438.
Provider's Profile
| Full Name | Stacy M Pemberton |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 298 Sequatchie Mountain Rd, Sequatchie, Tennessee |
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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. |
Medical Education and Training:
- Stacy M Pemberton graduated from nursing school in 2024
NPI Data:
- NPI Number: 1063241438
- Provider Enumeration Date: 08/01/2024
- Last Update Date: 08/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 6406381813
- Enrollment ID: I20241121004536
Medical Identifiers
Medical identifiers for Stacy M Pemberton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1063241438 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 36877 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Knoxville Center For Behavioral Medicine Llc | 0244624195 | 11 |
| Volunteer Behavioral Health Care System | 3678485802 | 45 |
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. Stacy M Pemberton allows following entities to bill medicare on her behalf.
| Entity Name | Volunteer Behavioral Health Care System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043267107 PECOS PAC ID: 3678485802 Enrollment ID: O20031206000098 |
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| Entity Name | Erlanger Behavioral Health, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306354790 PECOS PAC ID: 3870857949 Enrollment ID: O20181119003389 |
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| Entity Name | Knoxville Center For Behavioral Medicine Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710640776 PECOS PAC ID: 0244624195 Enrollment ID: O20230608000113 |
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| Entity Name | Cookeville Psychiatric Solutions Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740064245 PECOS PAC ID: 4981054350 Enrollment ID: O20231227001818 |
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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. Stacy M Pemberton 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 |
Stacy M Pemberton, 298 Sequatchie Mountain Rd, Sequatchie, TN 37374-5000 Ph: (423) 605-7415 | Stacy M Pemberton, 298 Sequatchie Mountain Rd, Sequatchie, TN 37374-5000 Ph: (423) 605-7415 |
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