Johannah Elizabeth Stephens

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

200340897RN Issued in OR

Practice address

375 NW Beaver St Ste 100
Prineville, OR 97754-1802

Phone

(541) 447-5165

Fax

(541) 447-3093

NPI assigned

Jan 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1043963341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 NW BEAVER ST STE 100",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541802",
            "telephone_number": "541-447-5165",
            "fax_number": "541-447-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 NW BEAVER ST STE 100",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541802",
            "telephone_number": "541-447-5165",
            "fax_number": "541-447-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JOHANNAH",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200340897RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Charles Health System, Inc.
• St. Charles Health System, Inc.
• St. Charles Health System, Inc.
• Micalene Stafford, LMT
• Justyn Reid Staten, CADC-I, PSS, CRM
• Matthew V Stern, RPH
• Kseniya A Stevens, L.AC., DIPL. O.M.
• Altara Sue Stever, CADC I
• Lindsey Stewart, QMHA
• Cynthia Stidd, LCSW

• Registered Nurse in Prineville, OR
• Providers in Prineville, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.