Individual provider Active NPI

Stephanie Munoz Nhim, RN, BSN, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1598371189
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021850 Issued in IL
Practice address
5930 Cornerstone CT W Ste 300
San Diego, CA 92121-3772
Phone
(858) 550-7107
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041430477 IL
Family Nurse Practitioner 363LF0000X 209021850 IL Primary

Addresses

Primary practice location

5930 Cornerstone CT W Ste 300
San Diego, CA 92121-3772

Mailing address

4440 Capstan Dr
Hoffman Estates, IL 60192-1006
Phone (224) 238-9117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20210330000589 IL Practitioner - Nurse Practitioner 1456768944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2923 N California Ave
Suite 210
Chicago, IL 60618-4677
Phone (773) 348-6876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041430477ILMDRegistered Nurse
209021850ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical Midwest, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1598371189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 CAPSTAN DR",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921006",
            "telephone_number": "224-238-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 CORNERSTONE CT W STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213772",
            "telephone_number": "858-550-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NHIM",
        "first_name": "STEPHANIE",
        "middle_name": "MUNOZ",
        "credential": "RN, BSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041430477",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.