Individual provider Active NPI

Stephanie Ann Valdivia, ARNP

  • Family Nurse Practitioner
  • Quincy, MA
National Provider Identifier
1902411820
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2352338 Issued in MA
Practice address
626 Southern Artery
Quincy, MA 02169-5648
Phone
(866) 389-2727
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X 9439320 FL
Family Nurse Practitioner 363LF0000X 2352338 MA
Family Nurse Practitioner 363LF0000X 11009677 FL
Family Nurse Practitioner 363LF0000X RN2352338 MA Primary

Addresses

Primary practice location

626 Southern Artery
Quincy, MA 02169-5648

Mailing address

626 Southern Artery
Quincy, MA 02169-5648
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9439320FLMDRehabilitation Registered Nurse
11009677FLMDFamily Nurse Practitioner
2352338MAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1902411820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 SOUTHERN ARTERY",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695648",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 SOUTHERN ARTERY",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695648",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIA",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "FL",
            "license": "9439320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2352338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009677",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2352338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.