NPIMap

Individual provider Active NPI

Stephanie Margaret Carpenter, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1629329537
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP-1229A Issued in ID
Practice address
2315 8TH St
Lewiston, ID 83501-7303
Phone
(208) 746-1383
Fax
(208) 746-6348
NPI assigned
Oct 2, 2012
Last updated
May 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-1229A ID
Family Nurse Practitioner 363LF0000X AP60511737 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP-1229A ID Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60511737 WA

Addresses

Primary practice location

2315 8TH St
Lewiston, ID 83501-7303

Mailing address

2315 8TH St
Lewiston, ID 83501-7303
Phone (208) 746-1383

Other identifiers 9

IdentifierTypeStateIssuer
1629329537OtherIDBLUE CROSS OF ID
1629329537OtherIDAETNA
1629329537OtherWAMOLINA HEALTHCARE OF WA
1629329537OtherIDREGENCE BLUE SHIELD OF ID
1629329537MedicaidID
1629329537MedicaidWA
1629329537OtherIDUNITED HEALTHCARE
1629329537OtherFCHN
1629329537OtherIDIPN

Other names 1

  • Stephanie Margaret Renne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130617000058 ID Practitioner - Nurse Practitioner 6204075633 Reassigns benefits to 3 organizations
I20130930000350 WA Practitioner - Nurse Practitioner 6204075633 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carpenter Health PLLCGroup PAC ID 6709241383, 2 clinicians
Blue Mountain Family Health PLLCGroup PAC ID 1153346028, 2 clinicians

Practice addresses (Care Compare)

1023 21St St
Lewiston, ID 83501-3415
Phone (509) 758-9524

1268 Bridge St
Clarkston, WA 99403-2219
Phone (509) 751-5500

1331 G St
Lewiston, ID 83501-1964
Phone (208) 717-2299

605 Joseph Ave
Winchester, ID 83555-5034
Phone (509) 552-9139

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60511737WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carpenter Health PLLC Family CurrentSince Aug 20, 2023 Accepting new patients
Thrive Behavioral Health LLC Psychiatric/Mental Health CurrentSince Nov 1, 2020 Accepting new patients
Blue Mountain Family Health PLLC CurrentSince Aug 1, 2024 Accepting new patients
Catalyst Medical Group, PLLC CurrentSince Jan 1, 2017 Accepting new patients
Ideal Option, PLLC Past Accepting new patients

Locations

1023 21st St
Lewiston, ID 83501
Phone (208) 743-1795

1331 G St
Lewiston, ID 83501
Phone (208) 717-2299

2315 8th St Grade
Lewiston, ID 83501
Phone (208) 746-1383

320 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1022

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1174 Alturas Dr
Moscow, ID 83843
Phone (208) 743-3523

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

1267 Belmont Way
Clarkston, WA 99403
Phone (509) 751-1500

1268 Bridge St
Clarkston, WA 99403
Phone (509) 758-9524

1372 Bridge St
Clarkston, WA 99403
Phone (509) 758-2568

808 Port Dr
Clarkston, WA 99403
Phone (208) 746-1383

827 6th St
Clarkston, WA 99403
Phone (208) 717-2288

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22732/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/27214/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HBCDAA
  • Direct secure messaging: stephanie.carpenter.1@22732.direct.athenahealth.com
  • Direct secure messaging: stephanie.carpenter.1@27214.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1629329537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 8TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017303",
            "telephone_number": "208-746-1383",
            "fax_number": "208-746-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 8TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017303",
            "telephone_number": "208-746-1383",
            "fax_number": "208-746-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "STEPHANIE",
        "middle_name": "MARGARET",
        "credential": "PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1229A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60511737",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "NP-1229A",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60511737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "1629329537",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1629329537",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE OF WA",
            "identifier": "1629329537",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "1629329537",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629329537",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629329537",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1629329537",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FCHN",
            "identifier": "1629329537",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IPN",
            "identifier": "1629329537",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "RENNE",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.