Stephanie J. Fangman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1030306 Issued in IN

Practice address

1120 N Marr Rd
Columbus, IN 47201-5505

Phone

(812) 376-9219

Fax

(812) 378-4821

NPI assigned

Jun 29, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1679501753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N. MARR ROAD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015501",
            "telephone_number": "812-376-9219",
            "fax_number": "812-378-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N MARR RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015505",
            "telephone_number": "812-376-9219",
            "fax_number": "812-378-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANGMAN",
        "first_name": "STEPHANIE",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "1030306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100358650",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000984524",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express LLC
• Kelly Falter, MCD, RD, LD, CNSC
• Families for Peace Inc
• Family Chiropractic and Wellness, LLC
• Family Service of Bartholomew County, Inc.
• Beth Fannin, MT
• Nhora Patricia Fant, PT
• Daphne Farmer, RBT
• Kalen Farr, DPM
• Dianne Farrar, LCSW

• All providers in Columbus, IN
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.