Individual provider Active NPI

Stephanie Raven, ND

  • Naturopath
  • Missoula, MT
National Provider Identifier
1871061630
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
AHC-NAT-LIC-1945 Issued in MT
Practice address
206 S 3Rd St W
Missoula, MT 59801-2524
Phone
(406) 493-0075
Fax
(888) 241-2059
NPI assigned
Nov 8, 2018
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X AHC-NAT-LIC-1945 MT Primary

Addresses

Primary practice location

206 S 3Rd St W
Missoula, MT 59801-2524

Mailing address

206 S 3Rd St W
Missoula, MT 59801-2524
Phone (406) 493-0075

Other identifiers 1

IdentifierTypeStateIssuer
AHC-NAT-LIC-1945OtherMTLICENSE

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

State licenses

LicenseStateTypeSpecialty
AHC-NAT-LIC-1945MTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Aralia Health, LLC Naturopath CurrentSince Jun 21, 2022 Accepting new patients
Doctor Amy Haynes Inc Naturopath PastSince Apr 1, 2021 Accepting new patients

Locations

206 S 3rd St W
Missoula, MT 59801
Phone (405) 926-1881

Organizations & group practices 2

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1871061630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012524",
            "telephone_number": "406-493-0075",
            "fax_number": "888-241-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012524",
            "telephone_number": "406-493-0075",
            "fax_number": "888-241-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVEN",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2023-03-07",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "MT",
            "license": "AHC-NAT-LIC-1945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AHC-NAT-LIC-1945",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.