Individual provider Active NPI

Stephanie Wilson, DNP

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1467973420
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A122450 Issued in IA
Practice address
5264 Council St NE
Cedar Rapids, IA 52402-2471
Phone
(319) 221-8444
NPI assigned
Jun 29, 2017
Last updated
Jun 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A122450 IA Primary

Addresses

Primary practice location

5264 Council St NE
Cedar Rapids, IA 52402-2471

Mailing address

5264 Council St NE Ste 100
Cedar Rapids, IA 52402-2477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20170731000198 IA Practitioner - Nurse Practitioner 5294006938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 378-8362

225 Welter Dr
Monticello, IA 52310-4722
Phone (319) 465-5937

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates, Inc Family Medicine CurrentSince Jul 10, 2017 Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Jul 10, 2017 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Current Accepting new patients
Mercy Care Management, Inc Family Medicine CurrentSince Jul 10, 2017 Accepting new patients
Mercy Physician Associates Inc Family Medicine CurrentSince Jul 10, 2017 Accepting new patients
Mercy Physician Associates, Inc Family Medicine Past Accepting new patients

Locations

5264 Council St NE
Cedar Rapids, IA 52402
Phone (319) 221-8444

5264 Council St NE
Ste 100
Cedar Rapids, IA 52402
Phone (319) 221-8444

1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362

300 W May St
Marengo, IA 52301
Phone (319) 462-8011

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1467973420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5264 COUNCIL ST NE STE 100",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5264 COUNCIL ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022471",
            "telephone_number": "319-221-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "A122450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.