Stephen Michael Nenninger, NMD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

369 Issued in CA

Practice address

1187 Coast Village Rd
Montecito, CA 93108-2737

Phone

(631) 235-2111

Fax

(631) 540-2345

NPI assigned

Sep 22, 2009

Last updated

Dec 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1295069318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RANDALL AVE",
            "address_2": "NPI MGT",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771638",
            "telephone_number": "631-235-2111",
            "fax_number": "631-551-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 COAST VILLAGE RD",
            "city": "MONTECITO",
            "state": "CA",
            "postal_code": "931082737",
            "telephone_number": "631-235-2111",
            "fax_number": "631-540-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "428 E Thunderbird Rd Ste 704",
            "address_2": "NPI RECEIVING DEPARTMENT AND MANAGEMENT",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850225229",
            "country_code": "US",
            "telephone_number": "631-235-2111",
            "fax_number": "631-551-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NENNINGER",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "05-869",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montecito Concierge Medicine
• Montecito Retirement Association (Casa Dorinda)
• Montecito Specialty Care a Professional Nursing Corp
• Eugene A Morales, LMFT 99419
• Joanne Sharon Moran, PH.D., PSY.D.
• Jason Bryan NG, PHARM.D.
• Northwinds Maui Wellness & Recovery Inc. (NorthWinds WellTox)
• Occhiali
• Sarah Oh
• Hedyeh Omranipour, PHARM. D.

• General Practice Physician in Montecito, CA
• Providers in Montecito, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.