Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colby Andrew Stack, NP

Individual provider Nurse Practitioner · NPI 1386414878

Colby Andrew Stack, NP is a Nurse Practitioner in Sullivan, Missouri. Qualified in 2021, 5 years ago. Practices with Missouri Baptist Hospital of Sullivan, a 40-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
5
Licensed in
MO
In the registry since
2024
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Phone: (573) 468-4186
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2024000101 (MO)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 2024000101 (MO)

Record details

NPI number1386414878
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 4, 2024
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025
Mailing address660 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8512

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Missouri Baptist Hospital Of Sullivan — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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