Active NPI
Stephanie Jean Hamersky, ATC
- Athletic Trainer
- Council Bluffs, IA
National Provider Identifier
1700453420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 917
- Practice address
- 241 Linden Ave
Council Bluffs, IA 51503-0447 - Phone
- (402) 676-5789
- NPI assigned
- Jun 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 917 | NE | Primary |
| Basic Emergency Medical Technician | 146N00000X | 24162 | NE |
Addresses
Primary practice location
241 Linden Ave
Council Bluffs, IA 51503-0447
Mailing address
241 Linden Ave
Council Bluffs, IA 51503-0447
Phone (140) 267-6578
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 917 | NE | MD | Professional Counselor |
| 24162 | NE | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1700453420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 LINDEN AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515030447",
"telephone_number": "140-267-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 LINDEN AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515030447",
"telephone_number": "402-676-5789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMERSKY",
"first_name": "STEPHANIE",
"middle_name": "JEAN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "917",
"primary": true
},
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "NE",
"license": "24162",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.