Individual provider Active NPI

Sara Marie Stevens, CNM

  • Advanced Practice Midwife
  • Trinity, FL
National Provider Identifier
1891183158
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11002398 Issued in FL
Practice address
2043 Little Rd
Trinity, FL 34655-4421
Phone
(727) 846-7000
NPI assigned
Jan 8, 2015
Last updated
May 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704296597 MI
Women's Health Nurse Practitioner 363LW0102X 4704296597 MI
Advanced Practice Midwife 367A00000X APRN11002398 FL Primary

Addresses

Primary practice location

2043 Little Rd
Trinity, FL 34655-4421

Mailing address

2043 Little Rd
Trinity, FL 34655-4421
Phone (727) 846-7000

Other practice location 1

212 S Sullivan Ave
Fremont, MI 49412-1548
Phone (231) 924-1212

Other identifiers 1

IdentifierTypeStateIssuer
1891183158MedicaidMI

Other names 1

  • Sara Marie Ippolito Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000607 FL Practitioner - Certified Nurse Midwife (CNM) 4284951922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4704296597MIMDWomen's Health Nurse Practitioner
APRN11002398FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of Manatee PA CurrentSince Jun 1, 2021 Accepting new patients

Locations

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

101 Avenue O SE
Winter Haven, FL 33880
Phone (863) 294-7010

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, 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": "1420675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1891183158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-846-7000",
            "fax_number": "727-440-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-846-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 S Sullivan Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "MI",
            "postal_code": "494121548",
            "country_code": "US",
            "telephone_number": "231-924-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-08",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704296597",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704296597",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11002398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891183158",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "IPPOLITO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.