STACEY S HODGES ACNP NPI 1104814805

NPI Information

NPI: 1104814805
Provider Name: STACEY S HODGES, ACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: TRANSSOUTH HEALTH CARE PC

PECOS Registration: Yes

Address:
9 PHYSICIANS DR
JACKSON, TN
ZIP 38305
Phone: (731) 661-0086
Get Directions

Stacey S Hodges, ACNP is an acute care nurse practitioner in Jackson, TN with 25 years of experience. Stacey S Hodges, ACNP NPI is 1104814805. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9 PHYSICIANS DR
JACKSON, TN
ZIP 38305
Phone: (731) 661-0086
Fax: (731) 661-0281

The NPI 1104814805 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/7/2005 and was last updated on 10/12/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	APN 7203	TENNESSEE	No
2	164W00000X	Licensed Practical Nurse		RN105802	TENNESSEE	No
3	363LA2100X	Nurse Practitioner	Acute Care	RN105802	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3902598	MEDICAID	TENNESSEE
2	3902591	MEDICARE PIN
3	MH0593346	OTHER		DEA
4	P27615	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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