Individual provider Active NPI

Stephanie Carson Kendrick, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
National Provider Identifier
1396767331
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-084436 Issued in AL
Practice address
2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone
(334) 528-5400
Fax
(334) 528-5421
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-084436 AL Primary

Addresses

Primary practice location

2000 Pepperell Pkwy
Opelika, AL 36801-5452

Mailing address

2601 Village Professional Dr N
Opelika, AL 36801-4784
Phone (334) 528-5400

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
I20061212000409 AL Practitioner - Nurse Practitioner 1456350818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Alabama Heart and Vascular, LLCGroup PAC ID 9638344708, 31 clinicians

Practice addresses (Care Compare)

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 528-5400

Hospital & facility affiliations

  • The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
64.65
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-084436ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Alabama Heart and Vascular, LLC CurrentSince Jul 24, 2020 Accepting new patients

Locations

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

2601 Village Professional Dr N
Opelika, AL 36801
Phone (334) 528-5959

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1396767331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 VILLAGE PROFESSIONAL DR N",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014784",
            "telephone_number": "334-528-5400",
            "fax_number": "334-528-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PEPPERELL PKWY",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015452",
            "telephone_number": "334-528-5400",
            "fax_number": "334-528-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "STEPHANIE",
        "middle_name": "CARSON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-084436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

Verify at the official NPI Registry.