Colby Andrew Stack, NP
NPI 1386414878ActiveIndividual· Nurse Practitioner· Sullivan, MO
Nurse Practitioner (NP) with Missouri Baptist Hospital of Sullivan, practicing in Sullivan, Missouri. Medicare paid $5,577 for services to 67 patients in 2024. Lists Missouri Baptist Medical Center and 1 other hospital as hospital affiliations.
Overview
| NPI | 1386414878 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NP |
| Sole proprietor | No |
| NPI issued | Jan 4, 2024 |
| Last updated in NPPES | Sep 19, 2025 |
| Certified by provider | Sep 19, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 2024000101 | MO |
| Nurse Practitioner, Acute Care | 363LA2100X | 2024000101 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 67 |
|---|---|
| Services billed | 71 across 6 procedure codes |
| Paid by Medicare | $5,577 |
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Missouri Baptist Hospital of SullivanSullivan, MO · 38 clinicians
Hospital affiliations
- Missouri Baptist Medical CenterSaint Louis, MO
- Missouri Baptist Sullivan HospitalSullivan, MO
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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