Individual provider Active NPI

Stephanie Dawn Davies, CRTT

  • Certified Respiratory Therapist
  • Idaho Falls, ID
National Provider Identifier
1932306222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Respiratory TherapistTaxonomy code 227800000X
License
LRT-192 Issued in ID
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 529-6111
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Respiratory Therapist 227800000X LRT-192 ID Primary
Certified Respiratory Therapist 227800000X 5411880-5701 UT

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

16804 Farmway Rd
Caldwell, ID 83607-9670
Phone (208) 455-3537

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

State licenses

LicenseStateTypeSpecialty
LRT-192IDMDCertified Respiratory Therapist
5411880-5701UTMDCertified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932306222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16804 FARMWAY RD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836079670",
            "telephone_number": "208-455-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "STEPHANIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "CRTT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "ID",
            "license": "LRT-192",
            "primary": true
        },
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "UT",
            "license": "5411880-5701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.