Individual provider Active NPI

Stephanie D Bowden, APRN

  • Gerontology Nurse Practitioner
  • Reno, NV
National Provider Identifier
1730949991
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
879240 Issued in NV
Practice address
1500 E 2ND St Ste 206
Reno, NV 89502-1198
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Mar 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 879240 NV Primary

Addresses

Primary practice location

1500 E 2ND St Ste 206
Reno, NV 89502-1198

Mailing address

1155 Mill Street M14
Reno, NV 89502-7301
Phone (775) 982-5262

Other identifiers 2

IdentifierTypeStateIssuer
879240OtherNVAPRN NV
16207492OtherNVCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240823003558 NV Practitioner - Nurse Practitioner 0244779031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1500 E 2ND St
Suite 206
Reno, NV 89502-1198
Phone (775) 982-3866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
879240NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Aug 15, 2024 Accepting new patients
Community Care Services LLC Current Accepting new patients
Community Care Services LLC CurrentSince Aug 15, 2024 Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

1500 E 2nd St
Ste 206
Reno, NV 89502
Phone (775) 789-7000

10201 Double R Blvd
Ste 315
Reno, NV 89521
Phone (775) 982-3443

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

Interoperability endpoints

  • Direct secure messaging: sercolin190103@direct.renown.org

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.

Hospital & facility affiliations 3

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": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1730949991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL STREET M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895027301",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 206",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "879240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN NV",
            "identifier": "879240",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16207492",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.