Individual provider Active NPI

Stephanie Miller Purcell, CRNP

  • Acute Care Nurse Practitioner
  • Malvern, PA
National Provider Identifier
1346912870
Registry record updated Mar 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP04666 Issued in PA
Practice address
100 Maxis Dr
Malvern, PA 19355-1327
Phone
(484) 321-5680
NPI assigned
Oct 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP04666 PA Primary

Addresses

Primary practice location

100 Maxis Dr
Malvern, PA 19355-1327

Mailing address

1711 Bow Tree Dr
West Chester, PA 19380-6465
Phone (610) 283-3718

Other practice location 1

933 E Haverford Rd
Bryn Mawr, PA 19010-3819
Phone (610) 520-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220119002357 PA Practitioner - Nurse Practitioner 5799177937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-8150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP04666PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Dec 22, 2021 Accepting new patients

Locations

933 E Haverford Rd
#150
Bryn Mawr, PA 19010
Phone (484) 337-5314

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

933 E Haverford Rd
Bryn Mawr, PA 19010
Phone (610) 527-3800

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 1

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 4

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": "1633219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710028800000",
    "number": "1346912870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 BOW TREE DR",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193806465",
            "telephone_number": "610-283-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAXIS DR",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551327",
            "telephone_number": "484-321-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 E Haverford Rd",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103819",
            "country_code": "US",
            "telephone_number": "610-520-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "STEPHANIE",
        "middle_name": "MILLER",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-03",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP04666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

Verify at the official NPI Registry.