Individual provider Active NPI

Carolyn Fay Brewer Stiefel, C.R.N.P

  • Nurse Practitioner
  • Fort Payne, AL
National Provider Identifier
1609891456
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-042428 Issued in AL
Practice address
205 Grand Ave NW
Suite B
Fort Payne, AL 35967-2107
Phone
(256) 979-1515
Fax
(256) 979-1517
NPI assigned
Jul 13, 2006
Last updated
Jan 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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 1-042428 AL Primary

Addresses

Primary practice location

205 Grand Ave NW
Suite B
Fort Payne, AL 35967-2107

Mailing address

205 Grand Ave NW
Suite B
Fort Payne, AL 35967-2107
Phone (256) 979-1515

Other identifiers 1

IdentifierTypeStateIssuer
891012960MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070103000337 AL Practitioner - Nurse Practitioner 3779583406 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Head Clinic LLCGroup PAC ID 0941326888, 7 clinicians

Practice addresses (Care Compare)

6110 County Rd
Suite 88
Pisgah, AL 35765

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-042428ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Clinic LLC CurrentSince Sep 25, 2017 Accepting new patients
Premier Medical Clinic LLC CurrentSince May 1, 2015 Accepting new patients
Med Care LLC CurrentSince Aug 10, 2015 Accepting new patients
Valley Head Clinic LLC CurrentSince May 1, 2015 Accepting new patients
Valley Head Clinic LLC CurrentSince Dec 8, 2021 Accepting new patients
Horizon Healthcare LLC CurrentSince Dec 8, 2021 Accepting new patients
Inphynet Contracting Services LLC Nurse Practitioner Past Accepting new patients
Paragon Contracting Services LLC Nurse Practitioner Past Accepting new patients

Locations

601 Corley Ave
Boaz, AL 35957
Phone (256) 558-3896

205 Grand Ave NW
Ste A
Fort Payne, AL 35967
Phone (256) 635-6600

205 Grand Ave NW
Ste B
Fort Payne, AL 35967
Phone (256) 979-1515

1436 Gunter Ave
Guntersville, AL 35976
Phone (256) 202-1111

6110 County Road 88
Pisgah, AL 35765
Phone (256) 451-1250

331 Parks Ave
Scottsboro, AL 35768
Phone (256) 259-4745

331 Parks Ave
Ste A
Scottsboro, AL 35768
Phone (256) 259-1635

503 Burlington St
Scottsboro, AL 35768
Phone (256) 259-1886

506 Harley St
Scottsboro, AL 35768
Phone (256) 259-1234

Organizations & group practices 8

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1609891456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GRAND AVE NW",
            "address_2": "SUITE B",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672107",
            "telephone_number": "256-979-1515",
            "fax_number": "256-979-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 GRAND AVE NW",
            "address_2": "SUITE B",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672107",
            "telephone_number": "256-979-1515",
            "fax_number": "256-979-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIEFEL",
        "first_name": "CAROLYN",
        "middle_name": "FAY BREWER",
        "name_prefix": "Ms.",
        "credential": "C.R.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-042428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891012960",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.