STACY LEIGH SEDERWALL (FNP) – Family Nurse Practitioner, NPI 1255720876

STACY LEIGH SEDERWALL (FNP) is a healthcare provider. based in Osage beach, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 2015001255 (MO). The NPI Number for STACY LEIGH SEDERWALL (FNP) is 1255720876

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
STACY LEIGH SEDERWALL (FNP)
NPI
1255720876
Phone
(573) 302-3199
Address
54 Hospital Dr Ste 213
Enumeration Date
20 January 2015
Last Update Date
26 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5738732521
Graduation Year
2014 (12 years ago)
PAC ID
2860719689
Group Practice PAC ID
9133026776
Professional Enrollment ID
I20150316001334
Address ID
MO650206819CA226XX54XX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Digital endpointsOther names

7,023 NURSE PRACTITIONER in MO

Provider Addresses for STACY LEIGH SEDERWALL (FNP)

  • 54 Hospital Dr Ste 213

    Osage Beach, MO 650653050

    Phone: (573) 302-3199

    Fax: (573) 302-3198

    Type: Location

  • 1057 Medical Park Dr

    Ste A

    Osage Beach, MO 650653000

    Phone: (573) 302-3200

    Fax: (573) 302-3210

    Type: Location

  • 2840 BAGNELL DAM BLVD

    LAKE OZARK, MO 650499732

    Phone: (573) 480-8888

    Fax: (502) 399-8745

    Type: Location

  • 54 HOSPITAL DR STE 213

    OSAGE BEACH, MO 650653050

    Phone: (573) 302-3199

    Fax: (573) 302-3198

    Type: Location

  • PO BOX 1500

    OSAGE BEACH, MO 650651500

    Phone:

    Type: Mailing

  • 2828 N National Ave

    Springfield, MO 658034306

    Phone: (573) 774-7474

    Fax: (573) 774-7575

    Type: Location

  • 1000 Hospital Rd

    Waynesville, MO 655832634

    Phone: (573) 774-5353

    Fax: (573) 774-2579

    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: 2015-03-16

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
I20150316001334INurse PractitionerMOTBD

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 65065)

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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: 9133026776View full group profile
NameSpecialtyState
-MO
Nurse PractitionerMO
N E U R O L O G YMO
Nurse PractitionerMO
Nurse PractitionerMO
Hematology/Oncology, Internal MedicineMO
Family PracticeMO
Nurse PractitionerMO
Nurse PractitionerMO
Family PracticeMO

Reviews

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Frequently asked questions

What is the 10-digit NPI for STACY LEIGH SEDERWALL (FNP)?
STACY LEIGH SEDERWALL (FNP) — NPI 1255720876 — is the standard way to identify this listing.
Is STACY LEIGH SEDERWALL (FNP) still practicing?
STACY LEIGH SEDERWALL (FNP) is currently listed as active in the public NPI registry.
What healthcare role does STACY LEIGH SEDERWALL (FNP) hold?
Scheduling teams often label STACY LEIGH SEDERWALL (FNP) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect STACY LEIGH SEDERWALL (FNP) on a map?
Expect Osage Beach, Missouri as a primary anchor for STACY LEIGH SEDERWALL (FNP) unless the record lists multiple sites.
How many locations tie to this NPI?
8 practice locations appear in the available data.

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