Individual provider Active NPI

Mia Stowe, FNP-C

  • Nurse Practitioner
  • Poland, IN
National Provider Identifier
1699243089
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F10181513 Issued in IN
Practice address
7667 E Private Road 375 N
Poland, IN 47868-6843
Phone
(812) 531-3115
NPI assigned
Nov 5, 2018
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F10181513 IN Primary
Registered Nurse 163W00000X 28204833A IN

Addresses

Primary practice location

7667 E Private Road 375 N
Poland, IN 47868-6843

Mailing address

7667 E Private Road 375 N
Poland, IN 47868-6843
Phone (812) 531-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190509002490 IN Practitioner - Nurse Practitioner 3173866399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Mobile MD Psychiatric Services LLCGroup PAC ID 9638564750, 18 clinicians

Practice addresses (Care Compare)

429 E Vermont St
Suite 110
Indianapolis, IN 46202-3685
Phone (317) 559-0950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F10181513INMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Mobile MD LLC CurrentSince Jul 14, 2022 Accepting new patients
My Mobile MD Psychiatric Services LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

429 E Vermont St
Ste 110
Indianapolis, IN 46202
Phone (765) 749-9871

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1699243089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7667 E PRIVATE ROAD 375 N",
            "city": "POLAND",
            "state": "IN",
            "postal_code": "478686843",
            "telephone_number": "812-531-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7667 E PRIVATE ROAD 375 N",
            "city": "POLAND",
            "state": "IN",
            "postal_code": "478686843",
            "telephone_number": "812-531-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWE",
        "first_name": "MIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "F10181513",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28204833A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, IN

Sources for this page

Verify at the official NPI Registry.