Organization Active NPI

Stefan Farrell Rnfa, PLLC

  • Perioperative Clinical Nurse Specialist
  • Phoenix, AZ
National Provider Identifier
1598778078
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Perioperative Clinical Nurse SpecialistTaxonomy code 364SP2800X
Legal business name
STEFAN FARRELL RNFA, PLLC
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(480) 844-9817
Fax
(480) 461-9195
NPI assigned
Aug 14, 2006
Last updated
Nov 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Mr. Stefan Brice Farrell, CNS, CRNFANPI 1275613960
Title
Owner
Phone
(480) 844-9817

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perioperative Clinical Nurse Specialist 364SP2800X NU Primary

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

PO Box 30361
Mesa, AZ 85275-0361
Phone (480) 844-9817

Other identifiers 6

IdentifierTypeStateIssuer
479073MedicaidAZ
890001034OtherRAILROAD
AZ 0167830OtherAZBC/BS
7562119OtherCIGNA
189762400OtherUS LABOR
1Z4109OtherAZHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611001447 AZ Part B Supplier - Clinic/Group Practice 9133102817 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ; Scottsdale, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1598778078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30361",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852750361",
            "telephone_number": "480-844-9817",
            "fax_number": "480-461-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "480-844-9817",
            "fax_number": "480-461-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFAN FARRELL RNFA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_middle_name": "BRICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-844-9817",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CNS, CRNFA"
    },
    "taxonomies": [
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479073",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "890001034",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "AZ 0167830",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7562119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US LABOR",
            "identifier": "189762400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z4109",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.