Individual provider Active NPI

Teresa L. Stephens, FNP-BC

  • Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1508957036
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-002662 Issued in IL
Practice address
2200 Wabash Ave
Springfield, IL 62704-5352
Phone
(217) 528-7541
NPI assigned
Sep 28, 2006
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-002662 IL Primary

Addresses

Primary practice location

2200 Wabash Ave
Springfield, IL 62704-5352

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other names 1

  • Teresa L. Stachowiak Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address teresastephens@sfc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-002662ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1508957036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045352",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "TERESA",
        "middle_name": "L.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-002662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teresastephens@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2200 Wabash Ave",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627045352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "STACHOWIAK",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.