Stephanie Margaret Carpenter, PMHNP-C
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Lewiston, ID
NPI 1629329537 · NPPES record last updated May 18, 2015
Key facts
- NPI
- 1629329537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- NP-1229A (ID)
- Practice address
- 2315 8TH St
Lewiston, ID 83501-7303 - Phone
- (208) 746-1383
- Fax
- (208) 746-6348
- NPI assigned
- Oct 2, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 15
Medicare Care Compare profile
- 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 PLLC
Blue Mountain Family Health PLLC
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
- St Mary'S Hospital
- Gritman Medical Center
- Clearwater Valley Hospital & Clinics
- Tri-State Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130617000058 | ID | Practitioner - Nurse Practitioner | 6204075633 | Reassigns benefits to 3 organizations |
| I20130930000350 | WA | Practitioner - Nurse Practitioner | 6204075633 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60511737 | WA | MD | Family Nurse Practitioner |
| NP-1229A | ID | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catalyst Medical Group, PLLC | Current |
Accepting new patients | |
| Carpenter Health PLLC | Family | Current |
Accepting new patients |
| Blue Mountain Family Health PLLC | Current |
Accepting new patients | |
| Thrive Behavioral Health LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
1331 G St
Lewiston, ID 83501
Phone (208) 717-2299
1023 21st St
Lewiston, ID 83501
Phone (208) 743-1795
320 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1022
415 6th St
Lewiston, ID 83501
Phone (208) 750-7445
2315 8th St Grade
Lewiston, ID 83501
Phone (208) 746-1383
1174 Alturas Dr
Moscow, ID 83843
Phone (208) 743-3523
1268 Bridge St
Clarkston, WA 99403
Phone (509) 758-9524
1267 Belmont Way
Clarkston, WA 99403
Phone (509) 751-1500
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
1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HBCDAA
- https://api.platform.athenahealth.com/22732/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/27214/brand/1/csg/1/fhir/r4
- stephanie.carpenter.1@27214.direct.athenahealth.com
- stephanie.carpenter.1@22732.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP-1229A | ID | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP60511737 | WA | |
| Family Nurse Practitioner | 363LF0000X | NP-1229A | ID | |
| Family Nurse Practitioner | 363LF0000X | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629329537 | Other | ID | UNITED HEALTHCARE |
| 1629329537 | Other | ID | IPN |
| 1629329537 | Other | ID | AETNA |
| 1629329537 | Other | FCHN | |
| 1629329537 | Other | ID | BLUE CROSS OF ID |
| 1629329537 | Other | WA | MOLINA HEALTHCARE OF WA |
| 1629329537 | Medicaid | WA | |
| 1629329537 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 1629329537 | Medicaid | ID |
Other names
- Stephanie Margaret Renne
Other providers in Lewiston, ID
- John W Carlisle
- Mellissa Thell Carman
- Carmine Petracca
- Dean Carpenter
- Kailey Marie Carpenter
- Lincoln Carter
- Catalyst Medical Group, PLLC
- Catalyst Medical Group, PLLC
- Catalyst Medical Group, PLLC
- Catalyst Medical Group, PLLC
All providers in Lewiston, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.