Individual provider Active NPI

Stephanie Lynn Shortes, FNP-C

  • Nurse Practitioner
  • Pasadena, TX
National Provider Identifier
1831687185
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP137332 Issued in TX
Practice address
6503 Saint Jude Dr
Pasadena, TX 77505-5450
Phone
(281) 917-9209
NPI assigned
Apr 23, 2018
Last updated
Apr 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP137332 TX Primary

Addresses

Primary practice location

6503 Saint Jude Dr
Pasadena, TX 77505-5450

Mailing address

6503 Saint Jude Dr
Pasadena, TX 77505-5450
Phone (281) 917-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190130001375 TX Practitioner - Nurse Practitioner 2961749809 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Urgent Care PA Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients

Locations

1640 Lake Woodlands Dr
Ste E
The Woodlands, TX 77380
Phone (281) 367-0010

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.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1831687185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6503 SAINT JUDE DR",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775055450",
            "telephone_number": "281-917-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6503 SAINT JUDE DR",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775055450",
            "telephone_number": "281-917-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTES",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP137332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.