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STACEY C BOHM AGACNP-BC
NPI 1508484031
Nurse Practitioner - Acute Care in Statesville, NC

Active since July 10, 2020
1661 DAVIE AVE, STATESVILLE, NC 28677(704) 495-2470 Get Directions Write a Review

NPPES record last updated: August 26, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 26, 2021, Apr 21, 2021, Jul 10, 2020 (3 updates tracked since 2020).

About Stacey C Bohm Agacnp-bc NPPES

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

STACEY C BOHM AGACNP-BC (NPI 1508484031) is an individual acute care provider in Statesville, North Carolina, licensed in North Carolina (5013293) and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1508484031
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameSTACEY C BOHMCredential: AGACNP-BC
Location Address1661 DAVIE AVEStatesville, NC 28677-3519
Mailing Address1661 Davie AveStatesville, NC 28677-3519 · (704) 495-2470
Phone(704) 495-2470
Sole ProprietorNo
Enumeration DateJuly 10, 2020
Last NPPES UpdateAugust 26, 20213 updates tracked since enumeration
NPPES CertifiedAugust 26, 2021
✔ NPI 1508484031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
Licenses✔ Licensed in NC · 5013293✔ Licensed in VA · 0024179203
1661 DAVIE AVE, Statesville, NC 28677
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Other Providers at the Same Location NPPES

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

LAKE NORMAN MEDICAL, PLLC
Physical Medicine & Rehabilitation
1661 DAVIE AVE
STATESVILLE, NC 28677
Iredell County (704) 495-2470

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 Bohm's NPI number?

The NPI number for Stacey Bohm is 1508484031. It was assigned to this individual provider in the NPPES registry on July 10, 2020.

Where is Stacey Bohm located?

Stacey Bohm practices at 1661 Davie Ave, Statesville, NC 28677. The listed phone number is (704) 495-2470.

What is Stacey Bohm's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

When was this NPI record last updated?

The NPPES record for Stacey Bohm was last updated on August 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.