Individual provider Active NPI

Stephanie Bruno, APRN

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1134560667
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP124043 Issued in TX
Practice address
4330 Medical Dr
Ste 500
San Antonio, TX 78229-3318
Phone
(210) 558-0122
Fax
(210) 547-4909
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 734014 TX
Family Nurse Practitioner 363LF0000X 734014 TX
Family Nurse Practitioner 363LF0000X AP124043 TX Primary

Addresses

Primary practice location

4330 Medical Dr
Ste 500
San Antonio, TX 78229-3318

Mailing address

4330 Medical Dr
Ste 500
San Antonio, TX 78229-3318
Phone (210) 558-0122

Other names 1

  • Miss Stephanie Corey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160715000707 TX Practitioner - Nurse Practitioner 1850683558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Networks, Inc. 116 clinicians

Practice addresses (Care Compare)

4330 Medical Dr
Suite 500
San Antonio, TX 78229-3318
Phone (210) 558-0122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
734014TXMDFamily Nurse Practitioner
AP124043TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. CurrentSince May 14, 2018 Accepting new patients
Wellmed Medical Group, PA Past Accepting new patients

Locations

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

1715 McCullough Ave
Fl 2
San Antonio, TX 78212
Phone (210) 558-0122

Interoperability endpoints

  • Direct secure messaging: stephanie.bruno@wellmed.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1134560667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR",
            "address_2": "STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293318",
            "telephone_number": "210-558-0122",
            "fax_number": "210-547-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR",
            "address_2": "STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293318",
            "telephone_number": "210-558-0122",
            "fax_number": "210-547-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "734014",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "734014",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP124043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "COREY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.