Active NPI
Stephanie D. Baumgartner, CRNA
- Certified Registered Nurse Anesthetist
- Tuba City, AZ
National Provider Identifier
1801986476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP617253
- Practice address
- 167 North Main Street
Tuba City, AZ 86045-0600 - Phone
- (928) 283-2501
- Fax
- (928) 283-2677
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 617253 | TX | |
| Registered Nurse | 163W00000X | R48616 | NM | |
| Registered Nurse | 163W00000X | 74541 | SC | |
| Certified Registered Nurse Anesthetist | 367500000X | AP617253 | TX | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | R48616 | NM | |
| Certified Registered Nurse Anesthetist | 367500000X | 1356 | SC | |
| Certified Registered Nurse Anesthetist | 367500000X | 052041 | IL |
Addresses
Primary practice location
167 North Main Street
Tuba City, AZ 86045-0600
Mailing address
PO Box 600
167 North Main Street
Tuba City, AZ 86045-0600
Phone (928) 283-2501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 926214 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74541 | SC | MD | Registered Nurse |
| 052041 | IL | MD | Certified Registered Nurse Anesthetist |
| 1356 | SC | MD | Certified Registered Nurse Anesthetist |
| AP617253 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Kansas Pain & Anesthesia, PA | Past | Accepting new patients | |
| San Juan Regional Medical Center Inc | Past | Accepting new patients | |
| Wichita Anesthesiology Chartered | Past | Accepting new patients | |
| Four Corners Anesthesia, P.a. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Farmington, NM
- NPI 1093758831
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Hays, KS
- NPI 1366547333
-
- Pediatrics Physician
- Farmington, NM
- NPI 1093800534
-
- Anesthesiology Physician
- Wichita, KS
- NPI 1407848450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254268800000",
"number": "1801986476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 600",
"address_2": "167 NORTH MAIN STREET",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860450600",
"telephone_number": "928-283-2501",
"fax_number": "928-283-2677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 NORTH MAIN STREET",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860450600",
"telephone_number": "928-283-2501",
"fax_number": "928-283-2677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMGARTNER",
"first_name": "STEPHANIE",
"middle_name": "D.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2009-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "617253",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R48616",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "74541",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "AP617253",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "R48616",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "1356",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "052041",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "926214",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.