Individual provider Active NPI

Stephene Aizcorbe Hertwig, RN, MSN, ACNPC-AG

  • Critical Care Medicine Nurse Practitioner
  • Kalispell, MT
National Provider Identifier
1306379607
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
0024174096 Issued in VA
Practice address
350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone
(406) 257-8992
Fax
(406) 257-8996
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024174096 VA
Critical Care Medicine Nurse Practitioner 363LC0200X NUR-APRN-LIC-184834 MT
Critical Care Medicine Nurse Practitioner 363LC0200X 0024174096 VA Primary

Addresses

Primary practice location

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167

Mailing address

180 Meadow Vista Loop Unit D
Kalispell, MT 59901-2936
Phone (703) 626-4640

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shertwig142678@direct.healthsystem.virginia.edu Direct
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20220106002553 MT Practitioner - Nurse Practitioner 4880935998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

350 Heritage Way
Suite 2100
Kalispell, MT 59901-3167
Phone (406) 257-8992

Hospital & facility affiliations

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-184834MTMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Jan 31, 2022 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Jan 31, 2022 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients

Locations

350 Heritage Way
Ste 2300
Kalispell, MT 59901
Phone (406) 752-8456

1333 Surgical Services Way
Kalispell, MT 59901
Phone (406) 751-5392

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org
  • Direct secure messaging: shertwig142678@direct.healthsystem.virginia.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1306379607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 MEADOW VISTA LOOP UNIT D",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012936",
            "telephone_number": "703-626-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HERITAGE WAY STE 2100",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013167",
            "telephone_number": "406-257-8992",
            "fax_number": "406-257-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTWIG",
        "first_name": "STEPHENE",
        "middle_name": "AIZCORBE",
        "credential": "RN, MSN, ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024174096",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MT",
            "license": "NUR-APRN-LIC-184834",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "VA",
            "license": "0024174096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shertwig142678@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "501 Sunset Ln",
            "city": "Culpeper",
            "state": "VA",
            "country_code": "US",
            "postal_code": "227013917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.