Individual provider Active NPI

Stephanie Ruth Nani, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Grass Valley, CA
National Provider Identifier
1649470485
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
20A8801 Issued in CA
Practice address
565 Brunswick Rd Ste 1
Grass Valley, CA 95945-9529
Phone
(530) 274-7197
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 20A8801 CA Primary

Addresses

Primary practice location

565 Brunswick Rd Ste 1
Grass Valley, CA 95945-9529

Mailing address

565 Brunswick Rd Ste 1
Grass Valley, CA 95945-9529
Phone (530) 274-7197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101111000111 CA Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 0244249944 Practice locations: Nevada City, CA
I20161103001795 OR Practitioner - Osteopathic Manipulative MedicinePractitioner - General Practice 0244249944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: General Practice
Education
University of New England, College of Osteo Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15160 NW Laidlaw Rd
Suite 245
Portland, OR 97229-7709
Phone (503) 477-5180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8801CAMDNeuromusculoskeletal Medicine & OMM Physician
8801CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alive Health and Wellness, LLC CurrentSince Feb 13, 2025 Accepting new patients
Denise Olin, Inc. Past Accepting new patients
Health Conscious, Inc. Past Accepting new patients

Locations

15160 NW Laidlaw Rd
Ste 222
Portland, OR 97229
Phone (971) 294-9104

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1649470485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 BRUNSWICK RD STE 1",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459529",
            "telephone_number": "530-274-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 BRUNSWICK RD STE 1",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459529",
            "telephone_number": "530-274-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANI",
        "first_name": "STEPHANIE",
        "middle_name": "RUTH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20A8801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.