STACYE DICK (GNP-BC) – Gerontology Nurse Practitioner, NPI 1124455118

Gerontology Nurse Practitioner

STACYE DICK (GNP-BC) is a healthcare provider. based in Chantilly, Virginia. specializing in Gerontology Nurse Practitioner. They hold the professional credentials GNP-BC. They hold a License No. 256896 (TX). The NPI Number for STACYE DICK (GNP-BC) is 1124455118

Main info

Female

Sole Proprietor

35 Years Of Experience

Accepts Medicare Assignment

Name

STACYE DICK (GNP-BC)

NPI

1124455118

Phone

(571) 449-3585

Address

14121 PARKE LONG CT

Enumeration Date

4 October 2013

Last Update Date

4 October 2013

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2104772200

Graduation Year

1991 (35 years ago)

PAC ID

6800835588

Group Practice PAC ID

9133304603

Professional Enrollment ID

I20150204001955

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience38

Completeness75

Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for STACYE DICK (GNP-BC)

14121 PARKE LONG CT
SUITE 200 & 201
CHANTILLY, VA 201511647
Phone: (571) 449-3585
Fax: (800) 752-2471
Mailing address matches the actual address.

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 20151)

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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: 9133304603View full group profile

Name	Specialty	State
DAVID A BRICKEY (DO)	-	TX
JAMES HANFORD III KINSER (FNP-C)	-	TX
BRITTANY BOHL SMITH (FNP-C)	-	TX
SAMARA MCWILLIAMS	Nurse Practitioner	TX
JULIA PERRY WUTZ	Nurse Practitioner	GA
JOELY THORNHILL SCHRODER (APRN)	-	LA
ASHLYN ELYSE THOM (NP)	Nurse Practitioner	TX
MRS. DOMINIQUE PINILLA (FNP-C)	Nurse Practitioner	GA
MR. PAUL ANTHONY BRADLEY (AG-CNS BC)	-	TX
JOY DENMAN	Nurse Practitioner	TX