Individual provider Active NPI

Stephanie D Wynn, DNP, PMHNP-BC,FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Northport, AL
National Provider Identifier
1205113552
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-093340 Issued in AL
Practice address
2700 Hospital Dr
Northport, AL 35476-3360
Phone
(205) 886-3696
NPI assigned
Nov 14, 2011
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-093340 AL
Family Nurse Practitioner 363LF0000X AP70179177 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1171988 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP70179177 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 36804 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14311393-4405 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0103572-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-093340 AL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 79833 NM
Registered Nurse 163W00000X 1-093340 AL

Addresses

Primary practice location

2700 Hospital Dr
Northport, AL 35476-3360

Mailing address

2700 Hospital Dr
Northport, AL 35476-3360
Phone (205) 886-3696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140624001252 AL Practitioner - Nurse Practitioner 4082838537 Reassigns benefits to 3 organizations
I20241007003283 TX Practitioner - Nurse Practitioner 4082838537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

1430 Gadsden Hwy
Suite 116 917
Birmingham, AL 35235-3103
Phone (415) 360-3348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-093340ALMDFamily Nurse Practitioner
C-APN.0103572-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
79833NMMDPsychiatric/Mental Health Nurse Practitioner
36804TNMDPsychiatric/Mental Health Nurse Practitioner
1171988TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Brightside Medical, P.C. CurrentSince Sep 1, 2024 Accepting new patients
The DCH Healthcare Authority Current Accepting new patients
DCH Provider Services, LLC CurrentSince Dec 1, 2020 Accepting new patients
DCH Provider Services, LLC Current Accepting new patients

Locations

1430 Gadsden Hwy
Ste 116917
Birmingham, AL 35235
Phone (208) 623-9050

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

1110 Dr Edward Hillard Dr
Ste A
Tuscaloosa, AL 35401

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

801 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 759-7800

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

Organizations & group practices 5

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": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1205113552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-886-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-886-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "DNP, PMHNP-BC,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-093340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP70179177",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1171988",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70179177",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36804",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "14311393-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0103572-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-093340",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "79833",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-093340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.