Stephanie Anne Van Ham, FAMILY NURSE PRACTIT

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP2532 Issued in AZ

Practice address

2025 N 3Rd St
Suite170
Phoenix, AZ 85004-1471

Phone

(602) 462-1132

NPI assigned

Jun 22, 2007

Last updated

Jan 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 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

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.

• 4C Medical Group PLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558654384
  Medicare reassignment NPD
• 4C Medical Group PLC

  dba 4C Urgent Care

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1760688212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17218 N 72ND DR STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088581",
            "telephone_number": "623-334-8670",
            "fax_number": "480-488-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 N 3RD ST",
            "address_2": "SUITE170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041471",
            "telephone_number": "602-462-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HAM",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lynne Van Dyke, FNP-C
• Bailey Van Eyll, MD
• Van Go Activities, LLC
• Erin Van Gundy, DDS
• Jennifer Kay Van Gysel, RN
• Amelia Catherine Van Handel, M.D.
• Monica Meghan Van Hatten
• Laurelin Van Hoose, OTR/L
• Abigail Van Hulle
• Brendan Van Iten, DO

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.