Active NPI
Sara Marie Stevens, CNM
- Advanced Practice Midwife
- Trinity, FL
National Provider Identifier
1891183158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- APRN11002398
- Practice address
- 2043 Little Rd
Trinity, FL 34655-4421 - Phone
- (727) 846-7000
- NPI assigned
- Jan 8, 2015
- Last updated
- May 27, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891183158 | Medicaid | MI |
Other names 1
- Sara Marie Ippolito
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704296597 | MI | MD | Women's Health Nurse Practitioner |
| APRN11002398 | FL | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHP of Manatee PA | Current | 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.
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- NPI 1134771611
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.