Stephanie B. Pemberton, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP211489 Issued in ME

Practice address

6 Glen Cove Dr
Rockport, ME 04856-4272

Phone

(207) 301-8000

NPI assigned

Jun 28, 2016

Last updated

Nov 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Indiana University Health Bloomington Inc

  • Psychiatry Physician
  • Bloomington, IN
  • NPI 1871519074

  Psychiatric/Mental Health

  NPD
• Indiana University Health Bloomington Inc

  dba IU Health Bloomington Retail Pharmacy

  • Community/Retail Pharmacy
  • Bloomington, IN
  • NPI 1922640077
  NPD

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1205287513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLEN COVE DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GLEN COVE DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564272",
            "telephone_number": "207-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "STEPHANIE",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28174681A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP211489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Thomas Paine Jr., MD
• Jordan Douglas Palmer, CRNA, DNP
• India Pappas, M.D.
• Paradigm Dental PC (Camden Hills Dental Care)
• Amia Pelletier, MS, LAT, ATC
• Pen Bay General Surgery LLC
• Pen Bay Womens Imaging Specialists
• Penbay Anesthesia, LLC
• Penbay Dental LLC
• Penbay Neurology, P.a.

• Psychiatric/Mental Health Nurse Practitioner in Rockport, ME
• Providers in Rockport, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.