Active NPI
Ekaterina Stefanenko
- Student in an Organized Health Care Education/Training Program
- Tyler, TX
National Provider Identifier
1851967129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 11937 US Highway 271
Tyler, TX 75708-3154 - Phone
- (619) 560-6789
- NPI assigned
- May 27, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
11937 US Highway 271
Tyler, TX 75708-3154
Mailing address
5872 Old Jacksonville Hwy Apt 637
Tyler, TX 75703-0616
Phone (619) 560-6789
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1851967129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5872 OLD JACKSONVILLE HWY APT 637",
"city": "TYLER",
"state": "TX",
"postal_code": "757030616",
"telephone_number": "619-560-6789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11937 US HIGHWAY 271",
"city": "TYLER",
"state": "TX",
"postal_code": "757083154",
"telephone_number": "619-560-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEFANENKO",
"first_name": "EKATERINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.