Active NPI
Stephanie Roundtree, RN
- Case Management Registered Nurse
- Wildomar, CA
National Provider Identifier
1891122875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 704182
- Practice address
- 33713 Mill Pond Dr
Wildomar, CA 92595-7673 - Phone
- (619) 948-5214
- NPI assigned
- Oct 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 704182 | CA | Primary |
Addresses
Primary practice location
33713 Mill Pond Dr
Wildomar, CA 92595-7673
Mailing address
33713 Mill Pond Dr
Wildomar, CA 92595-7673
Phone (619) 948-5214
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 704182 | CA | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1891122875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33713 MILL POND DR",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "925957673",
"telephone_number": "619-948-5214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33713 MILL POND DR",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "925957673",
"telephone_number": "619-948-5214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUNDTREE",
"first_name": "STEPHANIE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "704182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wildomar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.