Elisa Stephens, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

38889.1584 Issued in WY

Practice address

640 E Broadway Ave
Jackson, WY 83001-8642

Phone

(307) 733-2046

Fax

(307) 733-6289

NPI assigned

Dec 30, 2010

Last updated

Jan 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, WY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mental Health & Recovery Services of Jackson Hole

  dba Curran-Seeley Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, WY
  • NPI 1578635462
  Medicare reassignment NPD
• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment NPD
• Changepoint Integrated Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holbrook, AZ
  • NPI 1205877610
  Medicare reassignment
• Mental Health & Recovery Services of Jackson Hole

  • Case Manager/Care Coordinator
  • Jackson, WY
  • NPI 1548137508
  NPD
• Southwest Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1225043755
  NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1730483082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1868",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011868",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "ELISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "38889.1584",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "WY",
            "license": "38889.1584",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN165748",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "AP3882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Sproule
• St John's Surgical Group, PC
• Samantha Stasi, MS CF-SLP
• Martha Gene Stearn, MD
• Matthew W Stech, PPC
• Michael Stern, D.M.D, PHD
• Steven Nelson, PHD, Inc.
• Anne Kathrine Stewart
• Ashley Drummond Stewart
• Natalie Cara Stewart, RN, NBC-HWC

• Psychiatric/Mental Health Nurse Practitioner in Jackson, WY
• Providers in Jackson, WY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.