Active NPI
Princess Stephenson, APRN, FNP-C
- Family Nurse Practitioner
- Clarksburg, MD
National Provider Identifier
1881155901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R206896
- Practice address
- 23202 Brewers Tavern Way
Clarksburg, MD 20871-4391 - Phone
- (301) 298-9919
- Fax
- (301) 298-9917
- NPI assigned
- Mar 29, 2019
- 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 | R206896 | MD | Primary |
Addresses
Primary practice location
23202 Brewers Tavern Way
Clarksburg, MD 20871-4391
Mailing address
23202 Brewers Tavern Way
Clarksburg, MD 20871-4391
Phone (301) 298-9919
Other names 1
- P. Marie Stephenson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- princess.stephenson.1@29188.direct.athenahealth.com
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.
-
- Family Nurse Practitioner
- Clarksburg, MD
- NPI 1356957252
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1881155901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23202 BREWERS TAVERN WAY",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208714391",
"telephone_number": "301-298-9919",
"fax_number": "301-298-9917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23202 BREWERS TAVERN WAY",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208714391",
"telephone_number": "301-298-9919",
"fax_number": "301-298-9917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "PRINCESS",
"name_prefix": "Mrs.",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-29",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R206896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "P. MARIE",
"last_name": "STEPHENSON",
"credential": "APRN, FNP-C",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Clarksburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.