Individual provider Active NPI

Stephanie Leonardson, NP-C

  • Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1194128025
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP1498A Issued in ID
Practice address
2985 Cortez Ave
Idaho Falls, ID 83404-7554
Phone
(208) 523-3373
Fax
(208) 523-8746
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP1498A ID Primary

Addresses

Primary practice location

2985 Cortez Ave
Idaho Falls, ID 83404-7554

Mailing address

2985 Cortez Ave
Idaho Falls, ID 83404-7554
Phone (208) 523-3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20141112002599 ID Practitioner - Nurse Practitioner 8325260094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074
  • Teton Valley Hospital Hospital, Driggs, ID, CCN 131313
  • Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP1498AIDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Oct 30, 2023 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

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

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

2985 Cortez Ave
Idaho Falls, ID 83404
Phone (208) 522-4600

450 E Main St
Fl 2
Rexburg, ID 83440

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

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.

Hospital & facility affiliations 6

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": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1194128025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-523-3373",
            "fax_number": "208-523-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-523-3373",
            "fax_number": "208-523-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDSON",
        "first_name": "STEPHANIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP1498A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.