Individual provider Active NPI

Stephanie Nicole Mott, CRNP

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1366633893
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1090851 Issued in AL
Practice address
810 Franklin St SE
Suite a
Huntsville, AL 35801-4310
Phone
(256) 533-7676
Fax
(256) 533-3171
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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 1090851 AL Primary

Addresses

Primary practice location

810 Franklin St SE
Suite a
Huntsville, AL 35801-4310

Mailing address

810 Franklin St SE
Suite a
Huntsville, AL 35801-4310
Phone (256) 533-7676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20041129000305 AL Practitioner - Nurse Practitioner 3779548037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huntsville Renal Clinic, PCGroup PAC ID 0749266237, 15 clinicians

Practice addresses (Care Compare)

810 Franklin St SE
Suite a
Huntsville, AL 35801-4310
Phone (256) 533-7676

810 Franklin St SE a
Huntsville, AL 35801-4310

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Highlands Medical Center Hospital, Scottsboro, AL, CCN 010061
  • Marshall Medical Centers Hospital, Boaz, AL, CCN 010005
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079
  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1090851ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Renal Clinic, PC CurrentSince Jan 8, 2008 Accepting new patients
Alabama Nephrologists Inc Past Accepting new patients
Creekside Family Practice Past Accepting new patients

Locations

810 Franklin St SE
#A
Huntsville, AL 35801
Phone (256) 533-7676

810 Franklin St SE
Huntsville, AL 35801
Phone (256) 533-7676

Interoperability endpoints

  • Direct secure messaging: smott24245@direct.acumenmd.com

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.

Hospital & facility affiliations 5

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1366633893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FRANKLIN ST SE",
            "address_2": "SUITE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014310",
            "telephone_number": "256-533-7676",
            "fax_number": "256-533-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FRANKLIN ST SE",
            "address_2": "SUITE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014310",
            "telephone_number": "256-533-7676",
            "fax_number": "256-533-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1090851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.