Stephanie Rose Fitzhenry, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN006480 Issued in PA

Practice address

120 Valley Green LN
King of Prussia, PA 19406-2079

Phone

(484) 324-7100

NPI assigned

Aug 15, 2022

Last updated

Aug 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Rose Kowalski Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1508584715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 CINNAMINSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281511",
            "telephone_number": "215-586-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VALLEY GREEN LN",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062079",
            "telephone_number": "484-324-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZHENRY",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KOWALSKI",
            "middle_name": "ROSE",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• First Avenue Occupational Medicine, LLC
• First Aveunue Occupational Medicine,LLC
• Tiana Fisher
• Christa Fitch
• John Delwon Fitch
• Shawn Fitzpatrick
• Samantha P Flanagan, D.O.
• Aubrey Flanigan
• Amanda H Fleischer, LMT
• Hannah Flohr

• Registered Dietitian in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.