Individual provider Active NPI

Stephanie Kennell-Heiling, NP

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1205313384
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
PENDING Issued in CA
Practice address
2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823
Phone
(141) 557-8310
Fax
(415) 291-0489
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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 PENDING CA Primary

Addresses

Primary practice location

2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20181017002193 CA Practitioner - Nurse Practitioner 1456603570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

2 Embarcadero Ctr
Lbby Level
San Francisco, CA 94111-3823
Phone (888) 663-6331

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGCAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Sep 10, 2018 Accepting new patients
One Medical Group, Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

1955 Broadway
Ste A
Oakland, CA 94612

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

130 Sutter St
Fl 2
San Francisco, CA 94104
Phone (415) 529-4522

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

2 Embarcadero Ctr
Lbby
San Francisco, CA 94111
Phone (415) 529-4566

4 Embarcadero Ctr
Lbby 2
San Francisco, CA 94111

110 Sutter St
Fl 6
San Francisco, CA 94104
Phone (415) 392-8200

2950 S Delaware St
Ste 150
San Mateo, CA 94403

1004 Northgate Dr
San Rafael, CA 94903
Phone (415) 590-6150

1299 Oakmead Pkwy
Sunnyvale, CA 94085
Phone (408) 266-3100

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.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1205313384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR LBBY LEVEL",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "141-557-8310",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELL-HEILING",
        "first_name": "STEPHANIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.