Individual provider Active NPI

Stephen J H Veronneau, MD

  • Aerospace Medicine Physician
  • Des Moines, WA
National Provider Identifier
1861706392
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
35055275 Issued in OH
Practice address
27427 12TH PL S
Des Moines, WA 98198-9418
Phone
(405) 623-2510
NPI assigned
Jul 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 35055275 OH Primary

Addresses

Primary practice location

27427 12TH PL S
Des Moines, WA 98198-9418

Mailing address

2200 S 216TH St
Des Moines, WA 98198-6547
Phone (405) 623-2510

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35055275OHMDAerospace Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1861706392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S 216TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986547",
            "telephone_number": "405-623-2510",
            "fax_number": "206-878-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27427 12TH PL S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981989418",
            "telephone_number": "405-623-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERONNEAU",
        "first_name": "STEPHEN",
        "middle_name": "J H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "OH",
            "license": "35055275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.