Active NPI
Misty D Wahab, ARNP
- Family Nurse Practitioner
- Council Bluffs, IA
National Provider Identifier
1861929168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A107947
- Practice address
- 933 E Pierce St
Council Bluffs, IA 51503-4626 - Phone
- (712) 396-4360
- Fax
- (712) 396-7069
- NPI assigned
- May 17, 2017
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A107947 | IA | Primary |
Addresses
Primary practice location
933 E Pierce St
Council Bluffs, IA 51503-4626
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861929168 | Medicaid | IA | |
| 10026327300 | Medicaid | NE |
Other names 1
- Misty D. Stephens
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unmc Physicians | Current | Accepting new patients |
Locations
Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731
988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600
Interoperability endpoints
- mwahab419685@direct.nebraskamed.com
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Omaha, NE
- NPI 1417912114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1861929168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-2100",
"fax_number": "402-354-6171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 E PIERCE ST",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034626",
"telephone_number": "712-396-4360",
"fax_number": "712-396-7069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHAB",
"first_name": "MISTY",
"middle_name": "D",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-17",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A107947",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1861929168",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026327300",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MISTY",
"last_name": "STEPHENS",
"middle_name": "D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.