MRS. STACI JEANNE SIDES (NP) – Adult Health Nurse Practitioner, NPI 1023567823

MRS. STACI JEANNE SIDES (NP) is a healthcare provider. based in Lebanon, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 71006609A (IN). The NPI Number for MRS. STACI JEANNE SIDES (NP) is 1023567823

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MRS. STACI JEANNE SIDES (NP)
NPI
1023567823
Phone
Not provided
Address
2705 N LEBANON ST STE 305
Enumeration Date
22 September 2016
Last Update Date
29 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7653350123
Graduation Year
2016 (10 years ago)
PAC ID
1850670357
Group Practice PAC ID
4082523170
Professional Enrollment ID
I20161123001583
Address ID
IN460529497LE400XXRDXX500

Contacts

Secure Messaging
staci.sides@whs.eclinicaldirectplus.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Other namesUpdated within 12 months

8,191 NURSE PRACTITIONER in IN

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Provider Addresses for MRS. STACI JEANNE SIDES (NP)

  • 305, North Lebanon Street, Lebanon, Boone County, Indiana, 46052, United States

    LEBANON, IN 460528622

    Phone:

    Type: Mailing

  • 400, Mt Zion Road, Lebanon Industrial Complex, Lebanon, Boone County, Indiana, 46052, United States

    LEBANON, IN 460529497

    Phone: (765) 335-0123

    Fax: (765) 335-0127

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-11-23

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
I20161123001583INurse PractitionerINTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes7574$0
87428Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza2424$0
81003Automated urinalysis test1917$0
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)1111$0
View full utilization report →

Insurance plans in this area (ZIP 46052)

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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: 4082523170View full group profile
NameSpecialtyState
Family PracticeIN
P O D I A T R YIN
-IN
-IN
O B S T E T R I C S/ G Y N E C O L O G YIN
Orthopedic SurgeryIN
-IN
Family PracticeIN
-IN
Physical Therapist In Private PracticeKY

Reviews

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Frequently asked questions

What is the registry number for MRS. STACI JEANNE SIDES (NP)?
The registry entry for MRS. STACI JEANNE SIDES (NP) shows NPI 1023567823.
Does the public listing show MRS. STACI JEANNE SIDES (NP) as active?
MRS. STACI JEANNE SIDES (NP)'s NPI record reflects an active status in NPPES.
What services align with MRS. STACI JEANNE SIDES (NP)'s listing?
MRS. STACI JEANNE SIDES (NP)'s public classification highlights Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MRS. STACI JEANNE SIDES (NP) tied to Lebanon, Indiana?
If you are local to Lebanon, Indiana, MRS. STACI JEANNE SIDES (NP) may be relevant to your search.
Why is information missing for MRS. STACI JEANNE SIDES (NP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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