Individual provider Active NPI

Stephanie A Niemi-Olson, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1699191072
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN126155 Issued in AZ
Practice address
2450 E River Rd
Tucson, AZ 85718-6526
Phone
(520) 795-7750
Fax
(520) 320-2155
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN126155 AZ Primary

Addresses

Primary practice location

2450 E River Rd
Tucson, AZ 85718-6526

Mailing address

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 795-7750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140528002008 AZ Practitioner - Nurse Practitioner 0648493288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurological Associates of TucsonGroup PAC ID 5092709527, 60 clinicians

Practice addresses (Care Compare)

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 795-7750

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN126155AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Tucson CurrentSince Nov 1, 2014 Accepting new patients

Locations

2450 E River Rd
Tucson, AZ 85718
Phone (520) 795-7750

Organizations & group practices 1

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": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1699191072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7750",
            "fax_number": "520-320-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7750",
            "fax_number": "520-320-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMI-OLSON",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN126155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.