Individual provider Active NPI

Stephanie Lauraine Hanenberg, NP

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1215123344
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
102754 Issued in CO
Practice address
1420 Austin Bluffs Pkwy
Colorado Springs, CO 80918-3733
Phone
(719) 262-4444
Fax
(719) 262-4446
NPI assigned
Sep 21, 2007
Last updated
Sep 21, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 102754 CO Primary

Addresses

Primary practice location

1420 Austin Bluffs Pkwy
Colorado Springs, CO 80918-3733

Mailing address

1420 Austin Bluffs Pkwy
Colorado Springs, CO 80918-3733
Phone (719) 262-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
102754COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth-El College of Nursing and Health Sciences Past Accepting new patients
University of Colorado at Colorado Springs Past Accepting new patients

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, 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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1215123344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183733",
            "telephone_number": "719-262-4444",
            "fax_number": "719-262-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183733",
            "telephone_number": "719-262-4444",
            "fax_number": "719-262-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANENBERG",
        "first_name": "STEPHANIE",
        "middle_name": "LAURAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "102754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.