Active NPI
Stephanie J Nanson, DPM
- Foot & Ankle Surgery Podiatrist
- Fullerton, CA
National Provider Identifier
1336237015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E4870
- Practice address
- 300 N Euclid St
Suite a
Fullerton, CA 92832-1623 - Phone
- (714) 888-6860
- Fax
- (714) 888-6867
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E4870 | CA | Primary |
Addresses
Primary practice location
300 N Euclid St
Suite a
Fullerton, CA 92832-1623
Mailing address
300 N Euclid St
Suite a
Fullerton, CA 92832-1623
Phone (714) 888-6860
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100164800A | Medicaid | IN | |
| 000000184576 | Other | IN | ANTHEM BCBS |
| 480008699 | Other | IN | RAILROAD MEDICARE |
| 4128970001 | Other | IN | MEDICARE DME |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4870 | CA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orange County Foot and Ankle Group, Inc. | Foot & Ankle Surgery | Past | Accepting new patients |
| Orange County Foot & Ankle Group, Inc. | Foot & Ankle Surgery | Past | Accepting new patients |
| John M Swangim DPM PC | Foot & Ankle Surgery | 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.
-
- Foot & Ankle Surgery Podiatrist
- Tustin, CA
- NPI 1396929774
-
- Foot & Ankle Surgery Podiatrist
- Fullerton, CA
- NPI 1639102833
-
- Foot & Ankle Surgery Podiatrist
- La Porte, IN
- NPI 1962722694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1336237015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N EUCLID ST",
"address_2": "SUITE A",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321623",
"telephone_number": "714-888-6860",
"fax_number": "714-888-6867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N EUCLID ST",
"address_2": "SUITE A",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321623",
"telephone_number": "714-888-6860",
"fax_number": "714-888-6867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANSON",
"first_name": "STEPHANIE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E4870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100164800A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000184576",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480008699",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DME",
"identifier": "4128970001",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.