Individual provider Active NPI

Stephanie Nicole Duffel, APN

  • Nurse Practitioner
  • Bono, AR
National Provider Identifier
1316193345
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A03142 Issued in AR
Practice address
9146 Highway 63 N
Bono, AR 72416-8153
Phone
(870) 930-9990
NPI assigned
Aug 11, 2008
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A03142 AR Primary

Addresses

Primary practice location

9146 Highway 63 N
Bono, AR 72416-8153

Mailing address

9146 Highway 63 N
Bono, AR 72416-8153
Phone (870) 930-9990

Other names 1

  • Ms. Stephanie Nicole Easley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20101117001053 AR Practitioner - Nurse Practitioner 0143415026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nea Reliant Health Care Professionals IncGroup PAC ID 0244530095, 6 clinicians

Practice addresses (Care Compare)

1045 W Main St C
Walnut RDG Fam Med Clin
Walnut Ridge, AR 72476-1004
Phone (870) 886-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A03142ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JT Dewitt, D.O., P.a. Current Accepting new patients
St Bernards Hospital Inc CurrentSince Apr 1, 2015 Accepting new patients
Nea Reliant Health Care Professionals Inc CurrentSince Apr 10, 2019 Accepting new patients
Surgical Associates of Jonesboro, Inc. Past Accepting new patients
St Bernards Clinics, Inc Past Accepting new patients
Caddoes Emergency Physicians LLC Nurse Practitioner Past Accepting new patients

Locations

9146 Highway 63 N
Bono, AR 72416
Phone (870) 930-9990

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

1045 W Main St
Walnut Ridge, AR 72476
Phone (870) 698-1123

1045 W Main St
#C
Walnut Ridge, AR 72476
Phone (870) 886-8300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12230/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1316193345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9146 HIGHWAY 63 N",
            "city": "BONO",
            "state": "AR",
            "postal_code": "724168153",
            "telephone_number": "870-930-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9146 HIGHWAY 63 N",
            "city": "BONO",
            "state": "AR",
            "postal_code": "724168153",
            "telephone_number": "870-930-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFEL",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A03142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "EASLEY",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bono, AR

Sources for this page

Verify at the official NPI Registry.