Stephanie Marie Deavila, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0997580-NP Issued in CO

Practice address

2875 International Cir
Colorado Springs, CO 80910-3144

Phone

(719) 389-0070

NPI assigned

Aug 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Munni Selagamsetty,MD,PC

  • Internal Medicine Physician
  • Colorado Springs, CO
  • NPI 1831360585
  Medicare reassignment NPD
• Internal Medicine of the Rockies

  • Adult Health Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1124287107
  NPD (past)

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1740908151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103144",
            "telephone_number": "719-389-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103144",
            "telephone_number": "719-389-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAVILA",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997580-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Deardorff
• Keith Alan Deardorff
• Jodi Kay Dearmont-Olson, FNP-C
• Alicia Deatherage
• Ellen Deaustin, O.T.
• Deb Elliott-Desorbo, PH.D., LLC
• Rebecca Debalski
• Debbie Roubal DDS, PC
• Pamela J Deberghes, MD
• Kathryn L Deblock, MA

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.