JERUSHA STACEY (RN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1114512746

JERUSHA STACEY (RN) is a healthcare provider. based in Tallahassee, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials RN. They hold a License No. RN069963 (GA). The NPI Number for JERUSHA STACEY (RN) is 1114512746

Main info

Female
43 Years Of Experience
Accepts Medicare Assignment
Name
JERUSHA STACEY (RN)
NPI
1114512746
Phone
(850) 599-3017
Address
112 WARE-RHANEY BUILDING 334 PALMER AVE EAST
Enumeration Date
5 March 2021
Last Update Date
19 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9122275468
Graduation Year
1983 (43 years ago)
PAC ID
0941640510
Group Practice PAC ID
5799772844
Professional Enrollment ID
I20240430001036
Address ID
GA317925740TH1102XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for JERUSHA STACEY (RN)

  • 112 WARE-RHANEY BUILDING 334 PALMER AVE EAST

    TALLAHASSEE, FL 323070001

    Phone: (850) 599-3017

    Type: Location

  • PO BOX 624

    OCHLOCKNEE, GA 317730624

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 30 Open Payments records for all available years, with a total value of $795.

Total Amount is formed as General ($795) + Research ($0) + Ownership ($0) = $795.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Alkermes, Inc. ($208).

Total Amount

$795

General + Research + Ownership

Payments

30

Total payment records

General Amount

$795

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240430001036INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32307)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799772844View full group profile

Reviews

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Frequently asked questions

Can I verify JERUSHA STACEY (RN) with an NPI only?
You can start verification with NPI 1114512746 for JERUSHA STACEY (RN), then check state licensing separately.
Is JERUSHA STACEY (RN) still practicing?
JERUSHA STACEY (RN) is currently listed as active in the public NPI registry.
What healthcare role does JERUSHA STACEY (RN) hold?
Scheduling teams often label JERUSHA STACEY (RN) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is JERUSHA STACEY (RN) based?
JERUSHA STACEY (RN) is tied to Tallahassee, Florida in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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