Individual provider Active NPI

Stephanie Marie Earls, RN

  • Registered Nurse
  • South Beach, OR
National Provider Identifier
1003240912
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
200341667RN Issued in OR
Practice address
342 SE 116TH St
South Beach, OR 97366-9729
Phone
(541) 867-7866
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 200341667RN OR Primary

Addresses

Primary practice location

342 SE 116TH St
South Beach, OR 97366-9729

Mailing address

342 SE 116TH St
South Beach, OR 97366-9729
Phone (541) 867-7866

Other identifiers 1

IdentifierTypeStateIssuer
200341667RNOtherOROREGON STATE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
200341667RNORMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1003240912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 SE 116TH ST",
            "city": "SOUTH BEACH",
            "state": "OR",
            "postal_code": "973669729",
            "telephone_number": "541-867-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 SE 116TH ST",
            "city": "SOUTH BEACH",
            "state": "OR",
            "postal_code": "973669729",
            "telephone_number": "541-867-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLS",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200341667RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF NURSING",
            "identifier": "200341667RN",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Beach, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.