Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1023355484 Individual Practitioner Female Practitioner

Stacy T Sullenberger , PNP

Nurse Practitioner - Pediatrics • Sidney, OH

Professional Overview & Biography Verified Profile Summary

Stacy Sullenberger, PNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Sidney, OH. Practice services are available at 915 MICHIGAN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

915 Michigan St

Sidney, OH 453652401

Telephone 9374984488
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Sidney, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Sidney, OH (1102 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-29
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License OH APRN.CNP.14148

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0330291 (OH)

Secondary Practice Locations

792 Northwoods Blvd

Vandalia, OH 453779462

Phone: 9376414236

4475 Far Hills Ave

Kettering, OH 454292405

Phone: 9376413141

3301 Dayton Xenia Rd Ste 200

Beavercreek, OH 454322759

Phone: 9376415098

662 N Main St

Springboro, OH 450669553

Phone: 9376415066

8501 Old Troy Pike

Huber Heights, OH 454241054

Phone: 9376414360

7787 Cox Ln

West Chester, OH 450696549

Phone: 9376415757

1711 Germantown Pike

Dayton, OH 45417

Phone: 9376413142

3333 W Tech Rd

Miamisburg, OH 453420955

Phone: 9376415725

1 Childrens Plz

Dayton, OH 454041815

Phone: 9376414000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Abigail Cable

Specialist/Technologist - Athletic Trainer

NPI 1013411479
Dr. Donald Smith , PHD RN AGACNP-BC NPC

Nurse Practitioner - Family

NPI 1043615420

PHDRNAGACNPBCNPC

NPI 1043886799

Doctor of Osteopathic Medicine (D.O.)

NPI 1063419935

Doctor of Optometry

NPI 1083608632

Registered Pharmacist

Kristen Hollis , ATC

Specialist/Technologist - Athletic Trainer

NPI 1104320571

Certified Athletic Trainer

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Business Mailing Address February 12, 2026

Registered at PO BOX 933421, CLEVELAND, OH 441930039 (Tel: 9376415072)

📍
Updated Practice Location July 29, 2025

Registered at 915 MICHIGAN ST, SIDNEY, OH 453652401 (Tel: 9374984488)

📍
Updated Practice Location January 05, 2021

Registered at 662 N MAIN ST, SPRINGBORO, OH 450669553 (Tel: 9376415066)

📍
Updated Business Mailing Address January 05, 2021

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041815 (Tel: 9376413555)

👤
Provider Name / Credentials Updated January 05, 2021

Recorded as STACY SULLENBERGER, PNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2021

Nurse Practitioner (License #APRN.CNP.14148 in OH)

📍
Updated Practice Location August 09, 2019

Registered at 662 N MAIN ST, SPRINGBORO, OH 45066 (Tel: 9376413000)

📍
Updated Business Mailing Address August 09, 2019

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041873 (Tel: 9376413000)

NPI Profile Active January 08, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location January 08, 2013

Registered at 1483 W MAIN ST, TIPP CITY, OH 453712803 (Tel: 9376678067)

📍
Updated Business Mailing Address January 08, 2013

Registered at 1483 W MAIN ST, TIPP CITY, OH 453712803

👤
Provider Name / Credentials Updated January 08, 2013

Recorded as STACY SULLENBERGER, CNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2013

Nurse Practitioner (License #14148 NP in OH)

🟢
Initial NPI Registration & Enumeration January 04, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Stacy Sullenberger. Be the first to share your experience!

Sign in to leave a review for Stacy Sullenberger

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1023355484
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2013
Last Update: May 29, 2026
Sole Proprietor: No

Mailing Address

Po Box 933421

Cleveland, OH 441930039

Phone: 9376415072

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.