STACEY LYNN HOLDER (CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1689322026

STACEY LYNN HOLDER (CNP) is a healthcare provider. based in Canal winchester, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. RN355876 (OH). The NPI Number for STACEY LYNN HOLDER (CNP) is 1689322026

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
STACEY LYNN HOLDER (CNP)
NPI
1689322026
Phone
(614) 795-0311
Address
3919 SUGARBARK DR
Enumeration Date
15 March 2022
Last Update Date
7 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4408356212247
Graduation Year
2022 (4 years ago)
PAC ID
6002273752
Group Practice PAC ID
1153227848
Professional Enrollment ID
I20230612001108
Address ID
OH441455256WE29133DRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for STACEY LYNN HOLDER (CNP)

  • 3919 SUGARBARK DR

    CANAL WINCHESTER, OH 431107711

    Phone: (614) 795-0311

    Type: Mailing

  • 235 MILL ST

    PATASKALA, OH 430628852

    Phone: (614) 795-0311

    Type: Mailing

  • 1800 ALLENTOWN RD

    LIMA, OH 458051873

    Phone: (614) 795-0311

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 18 Open Payments records for all available years, with a total value of $743.

Total Amount is formed as General ($743) + Research ($0) + Ownership ($0) = $743.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($236).

Total Amount

$743

General + Research + Ownership

Payments

18

Total payment records

General Amount

$743

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

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: 2023-06-12

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
I20230612001108INurse PractitionerOHTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes6131$0
View full utilization report →

Insurance plans in this area (ZIP 43110)

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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: 1153227848View full group profile
NameSpecialtyState
-OH
P S Y C H I A T R YOH

Reviews

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Frequently asked questions

Can I use this page to confirm STACEY LYNN HOLDER (CNP)'s NPI?
Yes. STACEY LYNN HOLDER (CNP) is listed with NPI 1689322026 in the public NPI dataset.
Can I rely on STACEY LYNN HOLDER (CNP) being an active provider?
As of the registry snapshot, STACEY LYNN HOLDER (CNP) is marked active.
What healthcare role does STACEY LYNN HOLDER (CNP) hold?
Scheduling teams often label STACEY LYNN HOLDER (CNP) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does STACEY LYNN HOLDER (CNP) list a practice location?
Patients near Canal Winchester, Ohio may find STACEY LYNN HOLDER (CNP) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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