Individual provider Active NPI

Stephanie Diane Bauerle, D.O.

  • Internal Medicine Physician
  • Union, MO
National Provider Identifier
1699834739
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006015211 Issued in MO
Practice address
1780 Old US Highway 50 E
Suite 115
Union, MO 63084-3397
Phone
(636) 583-8555
Fax
(636) 583-8559
NPI assigned
Dec 6, 2006
Last updated
Oct 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006015211 MO Primary

Addresses

Primary practice location

1780 Old US Highway 50 E
Suite 115
Union, MO 63084-3397

Mailing address

320 Buckhurst Dr
Ballwin, MO 63021-8346
Phone (636) 527-9141

Other names 1

  • Dr. Stephanie Diane Danieley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2006015211MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists, PC Past Accepting new patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients
Tennessee Health Partners LLC Internal Medicine PastSince Jan 1, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEJBAA

Organizations & group practices 4

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1699834739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BUCKHURST DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218346",
            "telephone_number": "636-527-9141",
            "fax_number": "636-527-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 OLD US HIGHWAY 50 E",
            "address_2": "SUITE 115",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630843397",
            "telephone_number": "636-583-8555",
            "fax_number": "636-583-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUERLE",
        "first_name": "STEPHANIE",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006015211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "DANIELEY",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.