Individual provider Active NPI

Stephanie Kovach

  • Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1174942767
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN 177047 Issued in AZ
Practice address
20827 N Cave Creek Rd
Phoenix, AZ 85024-4470
Phone
(602) 788-5890
NPI assigned
Apr 10, 2014
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 177047 AZ Primary
Registered Nurse 163W00000X RN 346411 OH

Addresses

Primary practice location

20827 N Cave Creek Rd
Phoenix, AZ 85024-4470

Mailing address

PO Box 3412
Carefree, AZ 85377-3412
Phone (602) 788-5890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN 177047AZMDRegistered Nurse
RN 346411OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Apn Staffing & Employment Solutions Past Accepting new patients

Organizations & group practices 1

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1174942767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3412",
            "city": "CAREFREE",
            "state": "AZ",
            "postal_code": "853773412",
            "telephone_number": "602-788-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20827 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244470",
            "telephone_number": "602-788-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN 177047",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 346411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.