NPIMap

Individual provider Active NPI

Stephanie Morgan, PA

  • Medical Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1316910797
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
GPA008 Issued in ID
Practice address
1660 John Adams Pkwy
Idaho Falls, ID 83401-4360
Phone
(208) 523-8844
Fax
(208) 529-8684
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X GPA008 ID Primary

Addresses

Primary practice location

1660 John Adams Pkwy
Idaho Falls, ID 83401-4360

Mailing address

1660 John Adams Pkwy
Idaho Falls, ID 83401-4360
Phone (208) 523-8844

Other identifiers 3

IdentifierTypeStateIssuer
000010154501OtherBLUE SHIELD OF IDAHO
807377800MedicaidID
PAC62OtherIDBLUE CROSS OF IDAHO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
GPA008IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Center for Reproductive Medicine Past Accepting new patients
Utah Fertility Center Past Accepting new patients
Life Spring Womens Clinic, P.a. Past Accepting new patients

Organizations & group practices 3

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1316910797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014360",
            "telephone_number": "208-523-8844",
            "fax_number": "208-529-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014360",
            "telephone_number": "208-523-8844",
            "fax_number": "208-529-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "GPA008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010154501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807377800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "PAC62",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.