Stacey Pfenning, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R27350 Issued in ND

Practice address

200 S 5TH St
Bismarck, ND 58504-5675

Phone

(701) 222-3937

Fax

(701) 222-8805

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1558405142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 5TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045675",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 5TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045675",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFENNING",
        "first_name": "STACEY",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R27350",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R27350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1451286",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19750",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500028258",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R27350",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Peterson
• Rachel Christine Petit, MA, CCC-SLP
• Gabriell Halee Petri Hancock, APRN, AGPCNP-BC
• Taylor Paige Pfeiffer
• Amy L Pfeiler, LRD
• Liza Jean Pfleger
• Destiny Suzanne Pfliiger
• Phillip T. Iero, M.D.,D.D.S., PC
• Sydney Phillips, DNP, APRN, FNP-C
• Phoenix Health Enterprises PLLC

• Family Nurse Practitioner in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.