Individual provider Active NPI

Nina J Stowe, CRNP

  • Family Nurse Practitioner
  • Russellville, AL
National Provider Identifier
1467464784
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1047048 Issued in AL
Practice address
14001 Hwy. 43, Suite 24
Russellville, AL 35653-0221
Phone
(256) 398-7212
Fax
(256) 398-7213
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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 1047048 AL Primary

Addresses

Primary practice location

14001 Hwy. 43, Suite 24
Russellville, AL 35653-0221

Mailing address

14001 Hwy. 43, Suite 24
Russellville, AL 35653-0221
Phone (256) 398-7212

Other identifiers 1

IdentifierTypeStateIssuer
51526169OtherALBLUE CROSS

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
I20140320001419 AL Practitioner - Nurse Practitioner 4981835725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Medical, IncGroup PAC ID 2567749450, 4 clinicians

Practice addresses (Care Compare)

124 Jackson Ave S
Suite C
Russellville, AL 35653-2232
Phone (256) 398-7212

Hospital & facility affiliations

  • Russellville Hospital Hospital, Russellville, AL, CCN 010158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1047048ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HH Health System - Shoals LLC Current Accepting new patients
Mission Medical, Inc CurrentSince Apr 3, 2017 Accepting new patients

Locations

124 Jackson Ave S
Ste C
Russellville, AL 35653
Phone (256) 398-7212

14001 Highway 43
Ste 24
Russellville, AL 35653
Phone (256) 398-7212

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1467464784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 HWY. 43, SUITE 24",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530221",
            "telephone_number": "256-398-7212",
            "fax_number": "256-398-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 HWY. 43, SUITE 24",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530221",
            "telephone_number": "256-398-7212",
            "fax_number": "256-398-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWE",
        "first_name": "NINA",
        "middle_name": "J",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1047048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51526169",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AL

Sources for this page

Verify at the official NPI Registry.