Individual provider Active NPI

Bethany M Stern, FNP

  • Family Nurse Practitioner
  • Hazelwood, MO
National Provider Identifier
1801331152
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016038521 Issued in MO
Practice address
637 Dunn Rd Ste 170
Hazelwood, MO 63042-1759
Phone
(314) 838-5702
Fax
(314) 839-5596
NPI assigned
Dec 22, 2016
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016038521 MO Primary

Addresses

Primary practice location

637 Dunn Rd Ste 170
Hazelwood, MO 63042-1759

Mailing address

PO Box 419052
Saint Louis, MO 63141-9052
Phone (314) 851-1000

Other names 1

  • Bethany M Madrid Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20161230000055 MO Practitioner - Nurse Practitioner 5092096271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Multispecialty Group IncGroup PAC ID 1658365572, 118 clinicians

Practice addresses (Care Compare)

637 Dunn Rd
Suite 170
Hazelwood, MO 63042-1759
Phone (314) 838-5702

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016038521MOMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: bethany.madrid.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 1

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 2

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1801331152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419052",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631419052",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 DUNN RD STE 170",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421759",
            "telephone_number": "314-838-5702",
            "fax_number": "314-839-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "BETHANY",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016038521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "MADRID",
            "middle_name": "M",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hazelwood, MO

Sources for this page

Verify at the official NPI Registry.