Individual provider Active NPI

Stephanie L Ledl, NP

  • Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1730329640
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2002018100 Issued in MO
Practice address
2055 S Fremont Ave
Suite 1000
Springfield, MO 65804-2206
Phone
(417) 820-8099
Fax
(417) 820-8093
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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 2002018100 MO Primary

Addresses

Primary practice location

2055 S Fremont Ave
Suite 1000
Springfield, MO 65804-2206

Mailing address

2055 S Fremont Ave
Suite 1000
Springfield, MO 65804-2206
Phone (417) 820-8099

Other identifiers 4

IdentifierTypeStateIssuer
1730329640MedicaidMO
176560758MedicaidAR
431560263OtherTRICARE WEST
P00700785OtherRAILROAD MEDICARE

Other names 1

  • Stephanie L Skoglund Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090402000391 MO Practitioner - Nurse Practitioner 8527115856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2055 S Fremont Ave
1000 MC Cancer and Hematology
Springfield, MO 65804-2206
Phone (417) 820-8099

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Mercy Hospital Lebanon Hospital, Lebanon, MO, CCN 260059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002018100MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jan 15, 2019 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 1, 2009 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 1, 2009 Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2055 S Fremont Ave
Ste 200
Springfield, MO 65804
Phone (417) 820-3554

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2055 S Fremont Ave
Ste 1000
Springfield, MO 65804
Phone (417) 820-1347

2055 S Fremont Ave
#1000
Springfield, MO 65804
Phone (417) 820-8099

2055 S Fremont Ave
Fl 2
Springfield, MO 65804
Phone (417) 820-8099

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: sledl10260@directb.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1730329640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "address_2": "SUITE 1000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-8099",
            "fax_number": "417-820-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "address_2": "SUITE 1000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-8099",
            "fax_number": "417-820-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDL",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2002018100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730329640",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176560758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00700785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SKOGLUND",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.