MRS. STACEY CERVANTES (NPI# 1629077144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629077144 |
| Entity Type | Individual |
| Full Name | MRS. STACEY CERVANTES |
| Credential | ARNP |
| Practice Address |
1140 Sw Bascom Norris Dr Ste 104 Lake City FL 32025-1329 |
| Practice Telephone | 3867196500 |
| Practice Fax Number | 3867196503 |
| Mailing Telephone | 3867196500 |
| Mailing Fax Number | 3867196503 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2011-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP1477082 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 308846400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356539035 | Stacey Cervantes | Physical Therapist | 720 Florsheim Dr, Libertyville, IL 60048-3757 | 2007-10-09 |
| Street Address |
1140 SW BASCOM NORRIS DR STE 104 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736580 | Jamilyn Vaughn Jordan | Nurse Practitioner | 1140 Sw Bascom Norris Dr Ste 104, Lake City, FL 32025-1329 | 2019-05-28 |
| 1053829549 | Samantha Lawrence | Nurse Practitioner | 1140 Sw Bascom Norris Dr Ste 104, Lake City, FL 32025-1329 | 2018-01-18 |
| 1356513964 | Magnolia Pediatrics LLC | Pediatrics | 1140 Sw Bascom Norris Dr Ste 104, Lake City, FL 32025-1329 | 2008-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518584606 | Caroline Witt Nettles | Nurse Practitioner | 228 Nw Ranch Ct, Lake City, FL 32055-8922 | 2020-07-06 |
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1942321575 | Tracie Ledora Mitchem-green | Nurse Practitioner | 295 Nw Commons Loop # 115-105, Lake City, FL 32055-7721 | 2007-04-02 |
| 1366477002 | Mary Ellen Mclendon | Nurse Practitioner | 160 Se Saint Johns St, Lake City, FL 32025-4491 | 2006-07-11 |
| 1366471914 | Vida V Umstead | Nurse Practitioner | 4225 Nw American Ln, Lake City, FL 32055-8841 | 2006-07-03 |
| 1689654584 | Ira Lee | Nurse Practitioner | 777 W Duval St, Lake City, FL 32055-5806 | 2006-01-18 |
| 1346249406 | Matthew Neil Melvin | Nurse Practitioner | 1847 Sw Barnett Way, Lake City, FL 32025-6957 | 2005-07-20 |
| 1922007475 | Colleen A Thompson | Nurse Practitioner | 4196 W Us Highway 90, Ste 105, Lake City, FL 32055-8833 | 2005-07-18 |
| Find all providers in LAKE CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.