STACEY MCKINNON
NPI 1053823112
Nurse Practitioner - Family in Daytona Beach, FL
About Stacey Mckinnon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STACEY MCKINNON (NPI 1053823112) is an individual family provider in Daytona Beach, Florida, licensed in Florida (9242649) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, is affiliated with Halifax Health Medical Center, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Stacey Mckinnon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Stacey Mckinnon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Daytona Beach, FL 32114
- Reassigned Medicare billing, Florida enrollment
- 786 clinicians in this Medicare group
Miami, FL 33133
- Reassigned Medicare billing, Florida enrollment
- 716 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Halifax Health Medical Center
Acute Care Hospitals · Daytona Beach, FLAdventhealth Daytona Beach
Acute Care Hospitals · Daytona Beach, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DAYTONA BEACH, FL 32114
DAYTONA BEACH, FL 32114
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stacey Mckinnon's NPI number?
The NPI number for Stacey Mckinnon is 1053823112. It was assigned to this individual provider in the NPPES registry on October 30, 2017.
Where is Stacey Mckinnon located?
Stacey Mckinnon practices at 769 N Clyde Morris Blvd, Daytona Beach, FL 32114. The listed phone number is (386) 258-0123.
What is Stacey Mckinnon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Stacey Mckinnon enrolled in Medicare?
Yes. Stacey Mckinnon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Stacey Mckinnon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Mckinnon reassigns Medicare benefits to 2 organizations: Halifax Healthcare Systems Inc (Daytona Beach, FL) and Vitalmd Group Holding LLC (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacey Mckinnon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stacey Mckinnon accept?
Health plans from Oscar Health Maintenance Organization of Florida list Stacey Mckinnon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Stacey Mckinnon affiliated with any hospitals?
According to CMS data, Stacey Mckinnon is affiliated with Halifax Health Medical Center and Adventhealth Daytona Beach.
When was this NPI record last updated?
The NPPES record for Stacey Mckinnon was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Stacey Mckinnon · NPI 1053823112
Family physician in Daytona Beach, Florida. Individual provider, active in the CMS NPPES registry since October 30, 2017.
## Identity
- **NPI:** 1053823112 (Entity type: Individual)
- **Enumerated:** October 30, 2017
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 9242649 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 769 N CLYDE MORRIS BLVD, Daytona Beach, FL 32114-1603
- **Phone:** (386) 258-0123
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Halifax Healthcare Systems Inc (NPI 1245283530, Daytona Beach, FL); Vitalmd Group Holding LLC (NPI 1871572032, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** June 3, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1053823112) · Data from the CMS NPPES public registry.