NPIMap

Individual provider Active NPI

Stephanie Ann Hart, ARNP

  • Nurse Practitioner
  • Post Falls, ID
National Provider Identifier
1659692200
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
64956 Issued in ID
Practice address
1641 E Polston Ave Ste 102
Post Falls, ID 83854-2668
Phone
(208) 755-2804
Fax
(208) 765-0277
NPI assigned
Jun 17, 2010
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 64956 ID Primary
Family Nurse Practitioner 363LF0000X 64956 ID
Family Nurse Practitioner 363LF0000X AP60158260 WA

Addresses

Primary practice location

1641 E Polston Ave Ste 102
Post Falls, ID 83854-2668

Mailing address

3815 N Schreiber Way Ste 101
Coeur D Alene, ID 83815-8362
Phone (208) 755-2804

Other names 1

  • Ms. Stephanie Ann Fletcher Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200722001646 ID Practitioner - Nurse Practitioner 7719011220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beacon Cancer Care PLLCGroup PAC ID 6901158773, 15 clinicians

Practice addresses (Care Compare)

3815 N Schreiber Way
Unit 101
Coeur D Alene, ID 83815-8434
Phone (208) 755-2804

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60158260WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Cancer Care PLLC Nurse Practitioner CurrentSince Jul 27, 2020 Accepting new patients
Beacon Cancer Care PLLC CurrentSince Nov 17, 2024 Accepting new patients
Centerwell Certified Healthcare Corp. Past Accepting new patients
Family Home Care Corporation Past Accepting new patients

Locations

3815 N Schreiber Way
Unit 101
Coeur D Alene, ID 83815
Phone (208) 755-2804

980 W Ironwood Dr
Ste 207
Coeur D Alene, ID 83814
Phone (208) 755-2804

1641 E Polston Ave
Ste 102
Post Falls, ID 83854
Phone (208) 618-5212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1659692200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 N SCHREIBER WAY STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158362",
            "telephone_number": "208-755-2804",
            "fax_number": "208-765-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E POLSTON AVE STE 102",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838542668",
            "telephone_number": "208-755-2804",
            "fax_number": "208-765-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "64956",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "64956",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60158260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "FLETCHER",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.