Individual provider Active NPI

Stephanie Celine Douglass, CRNP

  • Nurse Practitioner
  • Butler, PA
National Provider Identifier
1891062709
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP011792 Issued in PA
Practice address
127 Oneida Valley Rd
Suite 400
Butler, PA 16001-2239
Phone
(866) 620-6761
Fax
(724) 631-0227
NPI assigned
Nov 20, 2011
Last updated
May 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP011792 PA Primary

Addresses

Primary practice location

127 Oneida Valley Rd
Suite 400
Butler, PA 16001-2239

Mailing address

127 Oneida Valley Rd
Suite 400
Butler, PA 16001-2239
Phone (866) 620-6761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130604000376 PA Practitioner - Nurse Practitioner 0143118141 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011792PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Butler Medical Providers CurrentSince Apr 22, 2013 Accepting new patients
Butler Medical Providers CurrentSince Apr 22, 2013 Accepting new patients
Butler Medical Providers Current Accepting new patients
Butler Medical Providers Past Accepting new patients
Butler Medical Providers Past Accepting new patients

Locations

127 Oneida Valley Rd
Ste 400
Butler, PA 16001
Phone (724) 431-0550

24 Doctors Ln
Ste 201
Clarion, PA 16214
Phone (833) 684-1898

Interoperability endpoints

  • Direct secure messaging: stephanie.douglass@direct-address.net

Organizations & group practices 5

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": "1321747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1891062709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 ONEIDA VALLEY RD",
            "address_2": "SUITE 400",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160012239",
            "telephone_number": "866-620-6761",
            "fax_number": "724-631-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ONEIDA VALLEY RD",
            "address_2": "SUITE 400",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160012239",
            "telephone_number": "866-620-6761",
            "fax_number": "724-631-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "STEPHANIE",
        "middle_name": "CELINE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-20",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.