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STACY SHOURT PNP
NPI 1700061470
Nurse Practitioner - Pediatrics in Syracuse, NY

Active since December 31, 2007
750 E ADAMS ST, SYRACUSE, NY 13210(315) 464-7231 Get Directions Write a Review

NPPES record last updated: November 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2020, Mar 28, 2018, Mar 12, 2018 (3 updates tracked since 2018).

About Stacy Shourt Pnp NPPES

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

STACY SHOURT PNP (NPI 1700061470) is an individual pediatrics provider in Syracuse, New York, licensed in New York (382505) and active in the NPI registry since December 2007.

NPPES Registry Identity

NPI1700061470
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSTACY SHOURTCredential: PNP
Location Address750 E ADAMS STSyracuse, NY 13210-2306
Mailing Address750 East Adams StSyracuse, NY 13210-2306 · (315) 464-5294 · Fax (315) 464-5294
Phone(315) 464-7231
Sole ProprietorNo
Enumeration DateDecember 31, 2007
Last NPPES UpdateNovember 25, 20243 updates tracked since enumeration
NPPES CertifiedMarch 6, 2020
✔ NPI 1700061470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
Licenses✔ Licensed in NY · 382505✔ Licensed in CA · 16823✔ Licensed in CO · 990023
750 E ADAMS ST, Syracuse, NY 13210
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Other Identifiers 2

Medicaid04523066NY
Medicaid79032273CO

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.

DAVID M KANTER MD
Physical Medicine & Rehabilitation
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5820
BRENNAN ELLIS M.D.
Emergency Medicine
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6202
UPSTATE UROLOGY, INC.
Urology
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6106
DR. AUDREY VICTORIA VANDEWALL DO
Pediatrics
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 408-5854
BETHANY A HAWKE MD
Emergency Medicine
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-4363
BILLAL MOHMAND MD
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5240
DAYANA NASR MD
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5240
JARROD THOMAS ELLIS
Student in an Organized Health Care Education/Training Program
750 E ADAMS ST
SYRACUSE, NY 13210
Onondaga County (315) 464-6635

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 Stacy Shourt's NPI number?

The NPI number for Stacy Shourt is 1700061470. It was assigned to this individual provider in the NPPES registry on December 31, 2007.

Where is Stacy Shourt located?

Stacy Shourt practices at 750 E Adams St, Syracuse, NY 13210. The listed phone number is (315) 464-7231.

What is Stacy Shourt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Stacy Shourt was last updated on November 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.