Individual provider Active NPI

Stephanie Silverman, FNP-C

  • Nurse Practitioner
  • Longview, TX
National Provider Identifier
1679941363
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP129269 Issued in TX
Practice address
709 Hollybrook Dr Ste 4500
Longview, TX 75605-2412
Phone
(903) 291-6114
Fax
(903) 291-6229
NPI assigned
Sep 11, 2015
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129269 TX Primary

Addresses

Primary practice location

709 Hollybrook Dr Ste 4500
Longview, TX 75605-2412

Mailing address

PO Box 610393
Dallas, TX 75261-0393
Phone (903) 757-6042

Other practice location 1

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042

Other identifiers 1

IdentifierTypeStateIssuer
351263404MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20151105000608 TX Practitioner - Nurse Practitioner 9335459247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

709 Hollybrook Dr
Suite 4500
Longview, TX 75605-2412
Phone (903) 757-6042

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Clinics of Longview CurrentSince Feb 20, 2017 Accepting new patients
Associated Clinicians of East Texas CurrentSince Sep 1, 2017 Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

1761 W Loop 281
Longview, TX 75604
Phone (903) 297-1733

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

709 Hollybrook Dr
Ste 4500
Longview, TX 75605
Phone (903) 757-6042

Interoperability endpoints

  • Direct secure messaging: stephanie.silverman.1@23550.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1679941363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610393",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752610393",
            "telephone_number": "903-757-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 HOLLYBROOK DR STE 4500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052412",
            "telephone_number": "903-291-6114",
            "fax_number": "903-291-6229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Hollybrook Dr",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756052410",
            "country_code": "US",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "STEPHANIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351263404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.