Colby Andrew Stack, NP in Sullivan, MO - Medicare Nurse Practitioner

Colby Andrew Stack, NP is a medicare enrolled "Nurse Practitioner" in Sullivan, Missouri. His current practice location is 751 Sappington Bridge Rd, Sullivan, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 468-4186.

Colby Andrew Stack is licensed to practice in Missouri (license number 2024000101) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386414878.

Contact Information

	Colby Andrew Stack, NP
	751 Sappington Bridge Rd, Sullivan, MO 63080-2354
	(573) 468-4186
	Not Available

Map and Direction

Provider's Profile

Full Name	Colby Andrew Stack
Gender	Male
Speciality	Nurse Practitioner
Location	751 Sappington Bridge Rd, Sullivan, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386414878
Provider Enumeration Date: 01/04/2024
Last Update Date: 09/19/2025

Medicare PECOS Information:

PECOS PAC ID: 0648619361
Enrollment ID: I20240415001653

Medical Identifiers

Medical identifiers for Colby Andrew Stack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386414878	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	2024000101 (Missouri)	Primary
363LA2100X	Nurse Practitioner - Acute Care	2024000101 (Missouri)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Colby Andrew Stack allows following entities to bill medicare on his behalf.

Entity Name	Missouri Baptist Hospital Of Sullivan
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295743169 PECOS PAC ID: 2668380148 Enrollment ID: O20060410000616

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Colby Andrew Stack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Colby Andrew Stack, NP 660 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8512 Ph: (618) 463-8500	Colby Andrew Stack, NP 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 Ph: (573) 468-4186

Reviews and Comments

Nurse Practitioner Nurses in Sullivan, MO

Mrs. Amy E Torres, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 573-860-6000
Mrs. Cinnamon Dale Michalik, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 751 Sappington Bridge Rd, Sullivan, MO 63080 Phone: 573-468-4186
Miranda Mae Pickens, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1326 S Service Rd W, Sullivan, MO 63080 Phone: 578-468-4455
Mary J Bjornstad, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 573-860-6000 Fax: 573-860-6016
Shelly Lynn Hulsey, CNM Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 314-747-1005
Allyson Marie Byron, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 573-860-6000 Fax: 573-860-6016
Mrs. Kamealya Leah Farrell, FNP-C, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1326 S Service Rd W Ste 10, Sullivan, MO 63080 Phone: 573-468-4455

Colby Andrew Stack, NP - Medicare Nurse Practitioner in Sullivan, MO