Stephanie Marie Poterack, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8364 Issued in AZ

Practice address

1230 W Cavedale Dr
Phoenix, AZ 85085-6367

Phone

(602) 301-1973

NPI assigned

Sep 16, 2015

Last updated

Apr 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stephanie.poterack.1@25035.direct.athenahealth.com
• Direct secure messaging: stephanie.poterack.1@28710.direct.athenahealth.com

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.

• Scottsdale Pediatrics and Pediatric Nephrology, PLLC

  dba Agave Pediatrics

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1629076518
  NPD (past)

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1407225733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 W CAVEDALE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856367",
            "telephone_number": "602-301-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 W CAVEDALE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856367",
            "telephone_number": "602-301-1973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7010 E Chauncey Ln",
            "address_2": "Suite 225",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850543111",
            "country_code": "US",
            "telephone_number": "480-585-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTERACK",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "144449",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Posto Sicuro
• Charles Bradley Poston
• Tracy Sandford Poston, PAC
• Adelaide Cadence Pote
• Potential Zone: Pathways to Growth Inc.
• Jeny M. Pothen Itty, D.O
• Jerrin Thomas Pothen, MD
• Madhavi Potluri, D.M.D
• Cheri M Pott, MD
• Amara Potter, COTA/L

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.