Active NPI
Amy Stowell
- Nurse Practitioner
- Granite City, IL
National Provider Identifier
1417571233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209021325
- Practice address
- 9 Paul Dr
Granite City, IL 62040-9646 - Phone
- (618) 531-1263
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209021325 | IL | Primary |
Addresses
Primary practice location
9 Paul Dr
Granite City, IL 62040-9646
Mailing address
9 Paul Dr
Granite City, IL 62040-9646
Phone (618) 531-1263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209021325 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1417571233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 PAUL DR",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620409646",
"telephone_number": "618-531-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 PAUL DR",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620409646",
"telephone_number": "618-531-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOWELL",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209021325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.