Individual provider Active NPI

Stephanie L Schaller, PPCNP

  • Pediatric Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1386611424
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2812 Issued in SC
Practice address
3710 Landmark Dr Ste 300
Columbia, SC 29204-4034
Phone
(803) 898-1470
Fax
(803) 898-1471
NPI assigned
Mar 8, 2006
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2812 SC Primary

Addresses

Primary practice location

3710 Landmark Dr Ste 300
Columbia, SC 29204-4034

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
NP0993MedicaidSC

Other names 1

  • Miss Stephanie L Villano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20060309000546 SC Practitioner - Nurse Practitioner 3072520493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2812SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 23, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 23, 2016 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

3710 Landmark Dr
Ste 300
Columbia, SC 29204
Phone (803) 434-3822

9 Richland Medical Park Dr
Ste 420
Columbia, SC 29203
Phone (803) 434-2833

Interoperability endpoints

  • Direct secure messaging: sschaller384276@direct.ghs.myhfn.org

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1386611424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-293-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 LANDMARK DR STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044034",
            "telephone_number": "803-898-1470",
            "fax_number": "803-898-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLER",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "2812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0993",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "VILLANO",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.