Individual provider Active NPI

Stephanie Bianca Espinoza, MD

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1083134720
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017021160 Issued in MO
Practice address
1 Hospital Dr.
Ma303, Dc032.00
Columbia, MO 65212
Phone
(573) 884-7060
Fax
(573) 884-4122
NPI assigned
Jun 23, 2017
Last updated
Jun 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 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 2017021160 MO Primary

Addresses

Primary practice location

1 Hospital Dr.
Ma303, Dc032.00
Columbia, MO 65212

Mailing address

1 Hospital Dr
Columbia, MO 65212-1000
Phone (573) 884-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20201023000380 TN Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 1951670975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Virginia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Camellia FoundationGroup PAC ID 0547439606, 11 clinicians

Practice addresses (Care Compare)

3030 Covington Pike
Suite 100
Memphis, TN 38128-5049
Phone (901) 432-5727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017021160MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Camellia Foundation Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Medicos General PLLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

3030 Covington Pike
#200
Memphis, TN 38128
Phone (901) 432-5727

3030 Covington Pike
Ste 100
Memphis, TN 38128
Phone (615) 277-0760

3040 Covington Pike
Memphis, TN 38128
Phone (901) 390-7921

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1083134720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-884-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR.",
            "address_2": "MA303, DC032.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65212",
            "telephone_number": "573-884-7060",
            "fax_number": "573-884-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOZA",
        "first_name": "STEPHANIE",
        "middle_name": "BIANCA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017021160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.