Individual provider Active NPI

Emma Marie Stephens

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1730778648
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
251899 Issued in AZ
Practice address
18422 W Roma Ave
Goodyear, AZ 85395-6462
Phone
(602) 573-9537
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 251899 AZ
Family Nurse Practitioner 363LF0000X 251899 AZ Primary

Addresses

Primary practice location

18422 W Roma Ave
Goodyear, AZ 85395-6462

Mailing address

1345 E Main St
Mesa, AZ 85203-8947
Phone (480) 404-7158

Other practice location 1

1345 E Main St
Mesa, AZ 85203-8947
Phone (480) 404-7158

Other identifiers 2

IdentifierTypeStateIssuer
F11200843MedicaidAZ
251899MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211104002011 AZ Practitioner - Nurse Practitioner 0446648836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians

Practice addresses (Care Compare)

10330 N Scottsdale Rd
Suite 25
Scottsdale, AZ 85253-1427
Phone (602) 255-7625

11685 W Van Buren St
Avondale, AZ 85323-6904
Phone (623) 465-6420

13901 W Meeker Blvd
Sun City West, AZ 85375-4475
Phone (623) 465-6435

15521 W Bell Rd
Surprise, AZ 85374-3437
Phone (623) 465-6390

4232 W Bell Rd
Glendale, AZ 85308-4027
Phone (623) 465-6360

7611 W Cactus Rd
Peoria, AZ 85381-5203
Phone (623) 465-6315

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Arizona LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Services, LLC Multi-Specialty Current Accepting new patients
Banner Urgent Care Services, LLC Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Services, LLC Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Arizona LLC Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients

Locations

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

3328 N Litchfield Rd
Goodyear, AZ 85395
Phone (623) 239-0394

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

7611 W Cactus Rd
Peoria, AZ 85381
Phone (623) 242-0049

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

10330 N Scottsdale Rd
Ste 25
Scottsdale, AZ 85253
Phone (602) 255-7625

7066 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 514-0344

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1730778648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038947",
            "telephone_number": "480-404-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18422 W ROMA AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853956462",
            "telephone_number": "602-573-9537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 E Main St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852038947",
            "country_code": "US",
            "telephone_number": "480-404-7158",
            "fax_number": "480-503-8151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "EMMA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "251899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "251899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F11200843",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251899",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.