Stephanie Marie Nelson, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101019369 Issued in MI

Practice address

1414 W Fair Ave
Suite 226
Marquette, MI 49855-2675

Phone

(906) 225-3925

Fax

(906) 225-4838

NPI assigned

Aug 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Stephanie Marie Humpula-McMahon Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.humpulamcmahon.1@8233.direct.athenahealth.com

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.

• Acquisition Bell Hospital LLC

  • Critical Access Hospital
  • Ishpeming, MI
  • NPI 1699101345
  Medicare reassignment NPD
• Bell Physician Practices Inc

  • Family Medicine Physician
  • Ishpeming, MI
  • NPI 1578992491
  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Pediatrics

  Medicare reassignment NPD
• Acquisition Bell Hospital LLC

  • Anesthesiology Physician
  • Ishpeming, MI
  • NPI 1013789015
  NPD
• Bell Physician Practices Inc

  • Rural Health Clinic/Center
  • Ishpeming, MI
  • NPI 1114726676
  NPD
• DLP Marquette Physician Practices Inc

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• DLP Marquette Physician Practices Inc

  • Pediatrics Physician
  • Marquette, MI
  • NPI 1356698971
  NPD
• DLP Marquette General Hospital LLC

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  NPD (past)
• DLP Marquette Physician Practices Inc

  • Emergency Medicine Physician
  • Marquette, MI
  • NPI 1366790727
  NPD (past)

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1245518521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26374 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731263",
            "telephone_number": "906-225-3630",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 226",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3925",
            "fax_number": "906-225-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245518521",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HUMPULA-MCMAHON",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregory Morgan Nelson, DC
• Karen K Nelson, MSW
• Katherine E Nelson, ND NATUROPATHIC PHYS
• Monica Marie Nelson
• Nichole Katherine Nelson
• Neurocare
• New Peninsula Pharmacy Plus LLC
• Christine Nguyen, MD
• Nicholas T Golba DDS PLLC
• Nick Raboin Chiropractic

• Pediatrics Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.