Individual provider Active NPI

Stephanie Lynn Haden, F.N.P.

  • Family Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1922761238
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN276839 Issued in MA
Practice address
46 Obery St
Plymouth, MA 02360-2237
Phone
(508) 830-6116
NPI assigned
Oct 14, 2021
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 276839 MA
Family Nurse Practitioner 363LF0000X RN276839 MA Primary

Addresses

Primary practice location

46 Obery St
Plymouth, MA 02360-2237

Mailing address

18 Sachem Dr
Sagamore Beach, MA 02562-2720
Phone (774) 836-2623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20211229002055 MA Practitioner - Nurse Practitioner 4183015142 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince Apr 16, 2023 Accepting new patients
Jordan Physician Associates, Inc. Family CurrentSince Apr 16, 2023 Accepting new patients
Health Imperatives Inc. Current Accepting new patients
Health Imperatives Inc. CurrentSince Oct 7, 2022 Accepting new patients

Locations

111 Torrey St
Brockton, MA 02301
Phone (508) 584-5190

942 W Chestnut St
#46
Brockton, MA 02301
Phone (508) 583-3005

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

Interoperability endpoints

  • Direct secure messaging: shaden151568@direct.bilh.masshiway.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1922761238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SACHEM DR",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622720",
            "telephone_number": "774-836-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-830-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADEN",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "276839",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN276839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.