Individual provider Active NPI

Stephanie McDonnaugh, PMHNP-BC,FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Millersville, MD
National Provider Identifier
1821209677
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R242409 Issued in MD
Practice address
1110 Benfield Blvd Ste H
Millersville, MD 21108-2644
Phone
(443) 788-9476
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LO-0000101 DE
Nurse Practitioner 363L00000X R242409 MD
Family Nurse Practitioner 363LF0000X LG-0000668 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0000180 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R242409 MD Primary

Addresses

Primary practice location

1110 Benfield Blvd Ste H
Millersville, MD 21108-2644

Mailing address

2618 Sequoia LN
Gambrills, MD 21054-1376
Phone (443) 788-9476

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 949-655-8724 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121026000480 DE Practitioner - Nurse Practitioner 2264682285 Reassigns benefits to 2 organizations
I20200923001342 MD Practitioner - Nurse Practitioner 2264682285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1110 Benfield Blvd
Suite H
Millersville, MD 21108-2644
Phone (443) 788-9476

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0000668DEMDFamily Nurse Practitioner
L8-0000180DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Associates, Inc CurrentSince Sep 9, 2012 Accepting new patients
Westside Family Healthcare, Inc. CurrentSince Apr 1, 2013 Accepting new patients
A Step to Wellness Family CurrentSince Aug 1, 2020 Accepting new patients

Locations

191 Christiana Rd
New Castle, DE 19720
Phone (302) 322-1794

191 Christiana Rd
Ste 3
New Castle, DE 19720
Phone (302) 322-1794

1802 W 4th St
Wilmington, DE 19805
Phone (302) 655-5576

908 E 16th St
Ste B
Wilmington, DE 19802
Phone (302) 225-1800

1110 Benfield Blvd
Ste H
Millersville, MD 21108
Phone (410) 693-6717

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1821209677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 SEQUOIA LN",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541376",
            "telephone_number": "443-788-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BENFIELD BLVD STE H",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082644",
            "telephone_number": "443-788-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNAUGH",
        "first_name": "STEPHANIE",
        "credential": "PMHNP-BC,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LO-0000101",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R242409",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000668",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0000180",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R242409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "949-655-8724",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1110 Benfield Blvd Ste H",
            "city": "Millersville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211082644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

Verify at the official NPI Registry.