Stephanie Videan, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704261894 Issued in MI

Practice address

760 W Franklin St
Jackson, MI 49201-2048

Phone

(517) 780-9260

NPI assigned

Oct 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• W. a. Foote Memorial Hospital, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MI
  • NPI 1326078866
  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• W.a. Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347

  Pediatrics

  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Wa Foote Memorial Hospital Inc.

  • Pediatrics Physician
  • Jackson, MI
  • NPI 1265806343
  NPD

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1669800975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012048",
            "telephone_number": "517-780-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W FRANKLIN ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012048",
            "telephone_number": "517-780-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDEAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704261894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Jenski Viaches
• Betsy Lynn Vickers, LMSW
• Victorian Villa Assisted Living LLC
• Victory Clinical Services
• Victory Clinical Services III LLC
• Teresa Vigor, PHARMD
• Bridget Katherine Villarreal, DC
• Crystal Villarreal
• Heidi J Vinaske
• Courtney Marie Vincent, LLMSW

• Pediatric Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.