Individual provider Active NPI

Stephanie L. Wheeler, M.D.

  • Family Medicine Physician
  • Kennewick, WA
National Provider Identifier
1073926978
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60680910 Issued in WA
Practice address
3180 W Clearwater Ave Ste a
Kennewick, WA 99336-2765
Phone
(509) 547-2204
NPI assigned
Jun 9, 2014
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60680910 WA Primary

Addresses

Primary practice location

3180 W Clearwater Ave Ste a
Kennewick, WA 99336-2765

Mailing address

521 Martin Luther King Jr Way
Tacoma Family Medicine
Tacoma, WA 98405-4238
Phone (253) 792-6680

Other identifiers 1

IdentifierTypeStateIssuer
2042923MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019002926 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 8527382399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Georgetown University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Community HealthGroup PAC ID 4183517469, 25 clinicians

Practice addresses (Care Compare)

3180 W Clearwater Ave
Suite a
Kennewick, WA 99336-2765
Phone (509) 547-2204

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Community Health CurrentSince Sep 18, 2017 Accepting new patients
Tri-Cities Community Health Current Accepting new patients
Tri-Cities Community Health Family Medicine Current Accepting new patients
Tri Cities Community Health Past Accepting new patients
Kadlec Regional Medical Center Past Accepting new patients

Locations

3180 W Clearwater Ave
Ste A
Kennewick, WA 99336

721 S Auburn St
Kennewick, WA 99336
Phone (509) 586-1157

515 W Court St
Pasco, WA 99301
Phone (509) 543-8520

829 Goethals Dr
Richland, WA 99352
Phone (509) 713-7331

Interoperability endpoints

  • Direct secure messaging: stephanie.wheeler.1@21034.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1073926978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MARTIN LUTHER KING JR WAY",
            "address_2": "TACOMA FAMILY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054238",
            "telephone_number": "253-792-6680",
            "fax_number": "253-403-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 W CLEARWATER AVE STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362765",
            "telephone_number": "509-547-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "STEPHANIE",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60680910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042923",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.