Individual provider Active NPI

Stephen A Henefield, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Nogales, AZ
National Provider Identifier
1245219179
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN138245 Issued in AZ
Practice address
1171 W Target Range Rd
Nogales, AZ 85621-2415
Phone
(520) 285-8010
NPI assigned
Jan 10, 2006
Last updated
Jan 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R 075850-1 MN
Certified Registered Nurse Anesthetist 367500000X RN138245 AZ Primary

Addresses

Primary practice location

1171 W Target Range Rd
Nogales, AZ 85621-2415

Mailing address

2202 N Forbes Blvd
Tucson, AZ 85745-1412
Phone (520) 872-7536

Other identifiers 3

IdentifierTypeStateIssuer
Z144889OtherAZMEDICARE PTAN
101828MedicaidAZ
702243300MedicaidMN

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN138245AZMDCertified Registered Nurse Anesthetist
R 075850-1MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Anesthesia Associates Nurse Anesthetist, Certified Registered Past Accepting new patients
Arizona Diagnostic Pathology Associates PLLC PastSince Oct 27, 2024 Accepting new patients
Carondelet Specialist Group, Inc PastSince Jan 1, 2010 Accepting new patients

Organizations & group practices 3

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1245219179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N FORBES BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451412",
            "telephone_number": "520-872-7536",
            "fax_number": "520-872-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 W TARGET RANGE RD",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212415",
            "telephone_number": "520-285-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEFIELD",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 075850-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN138245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z144889",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101828",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "702243300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.