Individual provider Active NPI

Stephanie Anne Sierra, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1447754643
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.023390 Issued in OH
Practice address
4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551
Phone
(614) 580-6917
Fax
(614) 547-8015
NPI assigned
Mar 21, 2018
Reactivated
Aug 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.023390 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.023390 OH Primary

Addresses

Primary practice location

4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551

Mailing address

4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551
Phone (614) 580-6917

Other identifiers 1

IdentifierTypeStateIssuer
0307763MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180925001434 OH Practitioner - Nurse Practitioner 5698026011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians
Concord Psychiatry, LLCGroup PAC ID 3577884105, 37 clinicians

Practice addresses (Care Compare)

4995 Bradenton Ave
Suite 130
Dublin, OH 43017-3551
Phone (614) 580-6917

50 Old Village Rd
Suite 109
Columbus, OH 43228-1538
Phone (614) 580-6917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Arts

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023390OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Psychiatry, LLC CurrentSince Jun 20, 2022 Accepting new patients
Oh Independent Medical Group LLC Past Accepting new patients

Locations

50 Old Village Rd
Ste 109
Columbus, OH 43228
Phone (614) 580-6917

4995 Bradenton Ave
Ste 130
Dublin, OH 43017
Phone (614) 580-6917

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.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1447754643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-580-6917",
            "fax_number": "614-547-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-580-6917",
            "fax_number": "614-547-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "deactivation_date": "2018-07-18",
        "reactivation_date": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.023390",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.023390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0307763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.