Stephanie C Welch, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006545 Issued in MI

Practice address

5515 Cleveland Ave
Stevensville, MI 49127-9670

Phone

(269) 429-6604

Fax

(269) 429-1715

NPI assigned

Dec 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1134464167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "address_2": "SUITE 2",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-439-6604",
            "fax_number": "269-429-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "STEPHANIE",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "56101006545",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134464167",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Erika Ann Walker, PA
• Jill S Wang, MD
• William H Ward, MD
• Richard A Watson
• Lisa M Willer, MS PT
• Jennifer D Williams, MSN, FNP-BC
• Bradford Wilson, TLLP
• Kimber Wooten-Toering, D.C.
• William Keith Wooten, D.C.

• Medical Physician Assistant in Stevensville, MI
• Providers in Stevensville, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.