STACY LATHAM APRN, PMHNP-BC
NPI 1457998809
Nurse Practitioner - Psychiatric/Mental Health in Poplar Bluff, MO

Q: What is Stacy Latham's NPI number?

The NPI number for Stacy Latham is 1457998809. It was assigned to this individual provider in the NPPES registry on December 4, 2019.

Q: What is Stacy Latham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Latham was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since December 04, 2019PECOS EnrolledAccepts Medicare Assignment

1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901(573) 686-4151(573) 778-4156 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: May 21, 2025, Dec 4, 2019 (2 updates tracked since 2019).

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About Stacy Latham Aprn, Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY LATHAM APRN, PMHNP-BC (NPI 1457998809) is an individual psychiatric/mental health provider in Poplar Bluff, Missouri, licensed in Missouri (2019045345) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS, is affiliated with Poplar Bluff Regional Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1457998809

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSTACY LATHAMCredential: APRN, PMHNP-BC

Location Address1500 N WESTWOOD BLVDPoplar Bluff, MO 63901-3318

Mailing Address1500 N Westwood BlvdPoplar Bluff, MO 63901-3318 · (573) 686-4151 · Fax (573) 472-7521

Phone(573) 686-4151

Fax(573) 778-4156

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateDecember 4, 2019

Last NPPES UpdateMay 21, 20252 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1457998809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MO · 2019045345

1500 N WESTWOOD BLVD, Poplar Bluff, MO 63901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stacy Latham Aprn, Pmhnp-bc 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.

PECOS PAC ID4880016963

PECOS Enrollment IDI20200618000207

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Poplar Bluff Regional Medical Center

Acute Care Hospitals · Poplar Bluff, MO

2/5 CMS rating

OwnershipProprietary

CMS Certification Number260119

Location3100 Oak Grove RoadPoplar Bluff, MO 63901 · Butler County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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