| Jody A Stark, NP | |
|
932 W Idaho Ave, Suite 100, Ontario, OR 97914-2155 | |
| (541) 889-2244 | |
| (541) 889-2626 |
| Full Name | Jody A Stark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 32 Years |
| Location | 932 W Idaho Ave, Ontario, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851472989 | NPI | - | NPPES |
| 500656154 | Medicaid | OR | |
| 500614019 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 200550081NP (Oregon) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 079043254N1 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Saint Alphonsus Medical Center - Ontario, Inc | Ontario, OR | Hospital |
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Stark Medical Group Pc | 4284873886 | 2 |
| Entity Name | Stark Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063754208 PECOS PAC ID: 4284873886 Enrollment ID: O20130611000546 |
| Mailing Address | Practice Location Address |
|---|---|
| Jody A Stark, NP Po Box J, Ontario, OR 97914-0020 Ph: (541) 889-2244 | Jody A Stark, NP 932 W Idaho Ave, Suite 100, Ontario, OR 97914-2155 Ph: (541) 889-2244 |
Halle Stutting, DNP, PNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 840 Sw 4th Ave Ste 105, Ontario, OR 97914 Phone: 541-881-2800 | |
Melissa D. Akin, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 932 W Idaho Ave, Ste 100, Ontario, OR 97914 Phone: 541-889-2244 | |
Mrs. Lindsay Wood, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1219 Sw 4th Ave Unit 1, Ontario, OR 97914 Phone: 541-709-4008 Fax: 541-920-0054 | |
Patsy Looney, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7 Sw 3rd St, Ontario, OR 97914 Phone: 541-889-2340 Fax: 541-889-2593 | |
Amber Mechelle Berger, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2327 Sw 4th Ave, Ontario, OR 97914 Phone: 541-889-2340 Fax: 541-889-2593 | |
Karmin Renae Maher-hasse, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1050 Sw 3rd Ave Ste 3200, Ontario, OR 97914 Phone: 208-302-0000 Fax: 208-302-0000 | |
Tami Beth Lamb, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 777 Stanton Blvd, Ontario, OR 97914 Phone: 541-881-5000 |