STACEY BETH CRUIKSHANK – Family Nurse Practitioner, NPI 1487289286

Family Nurse Practitioner

STACEY BETH CRUIKSHANK is a healthcare provider. based in Columbus, Ohio. specializing in Family Nurse Practitioner. They hold a License No. APRN.CNP.026491 (OH). The NPI Number for STACEY BETH CRUIKSHANK is 1487289286

Main info

Female

6 Years Of Experience

Accepts Medicare Assignment

Name

STACEY BETH CRUIKSHANK

NPI

1487289286

Phone

(614) 722-2000

Address

3553 Cleveland Ave

Enumeration Date

12 March 2020

Last Update Date

14 April 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6148647225

Graduation Year

2020 (6 years ago)

PAC ID

4486083656

Group Practice PAC ID

8426081357

Professional Enrollment ID

I20200409001205

Contacts

Main Contact

grovecity

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience41

Completeness95

Years active:6State licenses:1Other names

Provider Addresses for STACEY BETH CRUIKSHANK

3553 Cleveland Ave
Columbus, OH 432242909
Phone: (614) 722-2000
Type: Location
1657 Georgesville Square Dr
Columbus, OH 432283689
Phone: (614) 722-2000
Type: Location
882 S Hamilton Rd
Columbus, OH 432133003
Phone: (614) 722-2000
Type: Location
1350 Stringtown Rd
Grove City, OH 431239743
Phone: (614) 722-2000
Type: Location
1901 OHIO DR
GROVE CITY, OH 431234835
Phone:
Type: Mailing
700 Childrens Dr
Columbus, OH 432052664
Phone: (614) 722-2000
Type: Location
2599 E. Hamilton Rd
Columbus, OH 432324323
Phone: (614) 722-2000
Type: Location
2857 W Broad St
Columbus, OH 432042643
Phone: (614) 722-2000
Type: Location
1390 Cleveland Ave
Columbus, OH 432112767
Phone: (614) 722-2000
Type: Location
1125 E Main St
Columbus, OH 432051931
Phone: (614) 722-2000
Type: Location
4560 Morse Centre Rd
Columbus, OH 432296602
Phone: (614) 722-2000
Type: Location
5070 N High St
Columbus, OH 432141526
Phone: (614) 722-2000
Type: Location
1405 S High St
Columbus, OH 432071043
Phone: (614) 722-2000
Type: Location
1777 E Dublin Granville Rd
Columbus, OH 432293502
Phone: (614) 722-2000
Type: Location
433 N Cleveland Ave
Westerville, OH 430828095
Phone: (614) 722-2000
Type: Location
411 Industrial Mile Rd
Columbus, OH 432284322
Phone: (614) 722-2000
Type: Location
579 S Yearling Rd
Columbus, OH 432132874
Phone: (614) 722-2000
Type: Location
4766 W Broad St
Columbus, OH 432281613
Phone: (614) 722-2000
Type: Location
26 Hospital Dr
Athens, OH 457012471
Phone: (614) 722-2000
Type: Location
700 CHILDRENS DR
COLUMBUS, OH 432052664
Phone: (614) 722-2000
Type: Mailing
380 BUTTERFLY GARDENS DR
COLUMBUS, OH 432157508
Phone: (614) 722-2000
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: 2020-04-09

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

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20200409001205	I	Nurse Practitioner	OH	TBD

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 43224)

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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: 8426081357View full group profile

Name	Specialty	State
ROBERT K MAY (MD)	Family Practice	OH
DIANE LYNN WILLIAMS (RD, LD)	Registered Dietitian Or Nutrition Professional	OH
MRS. KAYLENE BLALOCK (MSN, FNP)	Nurse Practitioner	OH
EMILY DOUDNA (RD)	Registered Dietitian Or Nutrition Professional	OH
JENNIFER E THOMPSON (RD, LD)	Registered Dietitian Or Nutrition Professional	OH
JUDY LOPER (PHD, R.D;, L.D.)	Registered Dietitian Or Nutrition Professional	OH
MARY C FRIEND (MSN, APRN)	-	OH
JUDITH L. BROWN (MD)	Addiction Medicine, Internal Medicine	OH
MISS TERESA LEE DAVIS (CNP)	Nurse Practitioner	OH
ROBBIN MCSURLEY (R.D., L.D.)	Registered Dietitian Or Nutrition Professional	OH

Reviews

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Frequently asked questions

What is the 10-digit NPI for STACEY BETH CRUIKSHANK?

STACEY BETH CRUIKSHANK — NPI 1487289286 — is the standard way to identify this listing.

Does CMS list STACEY BETH CRUIKSHANK as active?

Yes — STACEY BETH CRUIKSHANK is active in the NPI listing used on this page.

What taxonomy line describes STACEY BETH CRUIKSHANK?

For research purposes, treat STACEY BETH CRUIKSHANK as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.

What address line appears for STACEY BETH CRUIKSHANK?

STACEY BETH CRUIKSHANK's geographic hint is Columbus, Ohio in our summary view.

Is the information about STACEY BETH CRUIKSHANK up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."