Stephanie Moore Canham, M.D.
Individual provider Active NPI Internal Medicine Physician · Bismarck, ND
NPI 1457614729 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1457614729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- PT14735 (ND)
- Practice address
- 209 N 7TH St
Bismarck, ND 58501-4441 - Phone
- (701) 323-5590
- NPI assigned
- Jun 20, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Washington University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Bismarck
Practice addresses (Care Compare)
209 N 7TH St
Bismarck, ND 58501-4441
Phone (701) 232-5590
Hospital & facility affiliations
- Sanford Home Care - HHA
- Caringedge Healthcare of Minot
- CHI Health at Home
- Sanford Medical Center Bismarck
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171004001786 | ND | Practitioner - Internal Medicine | 3274761184 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012018498 | MO | MD | Internal Medicine Physician |
| PT14735 | ND | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Bismarck | Current |
Accepting new patients | |
| Sanford Bismarck | Current |
Accepting new patients |
Locations
3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300
209 N 7th St
Bismarck, ND 58501
Phone (701) 323-2800
515 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5324
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | PT14735 | ND | Yes |
| Internal Medicine Physician | 207R00000X | 2012018498 | MO |
Addresses
Primary practice location
209 N 7TH St
Bismarck, ND 58501-4441
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9541
Other providers in Bismarck, ND
- Calming Waves Therapy PLLC
- Calming Waves Therapy PLLC
- Lacey Campbell
- Pamela G. Campbell
- Candor Professional Services, LLC
- William D Canham
- Michael Capan
- Capital Chiropractic PC
- Capital Foot and Ankle
- Capitol Eyecare PC
All providers in Bismarck, ND · Internal Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.