Individual provider Active NPI

Stephanie Romo, F.N.P.

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1265982326
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201608421NP-PP Issued in OR
Practice address
4035 S Stage Rd
Medford, OR 97501-9542
Phone
(949) 295-2740
Fax
(949) 799-4814
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 201608421NP-PP OR Primary

Addresses

Primary practice location

4035 S Stage Rd
Medford, OR 97501-9542

Mailing address

4035 S Stage Rd
Medford, OR 97501-9542
Phone (949) 295-2740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20161207002606 OR Practitioner - Nurse Practitioner 7214217355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Well Spring Health LLC CurrentSince Nov 9, 2021 Accepting new patients
CRM Physicians, LLC Family CurrentSince Jun 1, 2023 Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

1208 Beall Ln
Central Point, OR 97502

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

835 Crater Lake Ave
Medford, OR 97504
Phone (541) 507-4141

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1265982326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 S STAGE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975019542",
            "telephone_number": "949-295-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 S STAGE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975019542",
            "telephone_number": "949-295-2740",
            "fax_number": "949-799-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMO",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201608421NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.