Individual provider Active NPI

Patricia Stadler, FNP-C

  • Family Nurse Practitioner
  • Chubbuck, ID
National Provider Identifier
1124569108
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53856 Issued in ID
Practice address
570 Redman St
Chubbuck, ID 83202-2671
Phone
(602) 703-4196
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53856 ID Primary

Addresses

Primary practice location

570 Redman St
Chubbuck, ID 83202-2671

Mailing address

570 Redman St
Chubbuck, ID 83202-2671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170426002519 ID Practitioner - Nurse Practitioner 0446537526 Reassigns benefits to 3 organizations
I20200212000099 TX Practitioner - Nurse Practitioner 0446537526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Need-a-Nurse Medical Staffing, LLC 3 clinicians

Practice addresses (Care Compare)

476 E Chubbuck Rd
Chubbuck, ID 83202-1816
Phone (208) 233-9898

Hospital & facility affiliations

  • Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CC Pocatello LLC CurrentSince Mar 18, 2017 Accepting new patients
Need-a-Nurse Medical Staffing, LLC CurrentSince Oct 9, 2023 Accepting new patients
Mountain View Hospital LLC CurrentSince Jun 27, 2017 Accepting new patients
Mountain View Hospital LLC CurrentSince Jun 27, 2017 Accepting new patients
Shoshone Bannock Tribes, Inc Current Accepting new patients
Community Care Pocatello PLLC Current Accepting new patients
Need-a-Nurse Medical Staffing, LLC PastSince Oct 9, 2023 Accepting new patients
Shoshone-Bannock Community Health Center PastSince Jul 29, 2018 Accepting new patients

Locations

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

476 E Chubbuck Rd
Pocatello, ID 83202
Phone (208) 233-9898

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747

Interoperability endpoints

  • Direct secure messaging: patriciastadler@fmcoc-id.direct.office.nextgen.com

Organizations & group practices 9

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

Hospital & facility affiliations 2

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1124569108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 REDMAN ST",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 REDMAN ST",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022671",
            "telephone_number": "602-703-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADLER",
        "first_name": "PATRICIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "53856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

Verify at the official NPI Registry.