Susan Stambaugh, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.052695-MEDS Issued in OH

Practice address

1010 N Prospect St
Bowling Green, OH 43402-1335

Phone

(419) 352-5387

Fax

(419) 725-0676

NPI assigned

Sep 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1194126078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434020029",
            "telephone_number": "419-352-5387",
            "fax_number": "419-725-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N PROSPECT ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434021335",
            "telephone_number": "419-352-5387",
            "fax_number": "419-725-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBAUGH",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.052695-MEDS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LICENSE",
            "identifier": "PN.052695-MEDS",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jamie Stefango, PTA
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• Licensed Practical Nurse in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.