STACY A MARTIN (APRN) – Family Nurse Practitioner, NPI 1174132435

STACY A MARTIN (APRN) is a healthcare provider. based in Marianna, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN11008224 (FL). The NPI Number for STACY A MARTIN (APRN) is 1174132435

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
STACY A MARTIN (APRN)
NPI
1174132435
Phone
(850) 718-2531
Address
4250 HOSPITAL DR
Enumeration Date
23 July 2020
Last Update Date
29 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043302215
Graduation Year
2020 (6 years ago)
PAC ID
1850719733
Group Practice PAC ID
5092613570
Professional Enrollment ID
I20200909000762
Address ID
FL323241107CH100XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for STACY A MARTIN (APRN)

  • 4250 HOSPITAL DR

    MARIANNA, FL 324461917

    Phone: (850) 718-2531

    Fax: (850) 718-2844

    Type: Mailing

  • 4896 HIGHWAY 90 STE A

    MARIANNA, FL 324467840

    Phone: (850) 526-6700

    Fax: (850) 526-6701

    Type: Location

  • 100 N MAIN ST

    CHATTAHOOCHEE, FL 323241107

    Phone: (850) 793-6863

    Fax: (850) 663-1345

    Type: Mailing

  • 1798 Georgia St

    Alford, FL 324206800

    Phone: (850) 526-6727

    Fax: (850) 526-1027

    Type: Location

  • 4296 5th Ave

    Marianna, FL 324462173

    Phone: (850) 482-2061

    Fax: (850) 633-5911

    Type: Location

  • 4896 Highway 90 Ste A

    Marianna, FL 324467840

    Phone: (850) 526-6700

    Fax: (850) 526-6701

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-10-17 • Largest payer in this snapshot: TerSera Therapeutics LLC ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
TerSera Therapeutics LLC$21
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: 2020-09-09

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
I20200909000762INurse PractitionerFLTBD

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 32446)

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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: 5092613570View full group profile
NameSpecialtyState
Nurse PractitionerFL
General PracticeFL
Nurse PractitionerFL
General PracticeFL
General PracticeFL
Family PracticeFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Does STACY A MARTIN (APRN) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — STACY A MARTIN (APRN) uses 1174132435.
Does CMS list STACY A MARTIN (APRN) as active?
Yes — STACY A MARTIN (APRN) is active in the NPI listing used on this page.
What taxonomy line describes STACY A MARTIN (APRN)?
For research purposes, treat STACY A MARTIN (APRN) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for STACY A MARTIN (APRN)?
STACY A MARTIN (APRN)'s geographic hint is Marianna, Florida in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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