Stephanie Anne Fardal

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A173477 Issued in IA

Practice address

1025 SE Tallgrass LN Ste 220
Waukee, IA 50263-6817

Phone

(515) 875-9290

NPI assigned

Mar 2, 2023

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephaniefardal@tic.allscriptsdirect.net

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.

• The Iowa Clinic PC

  dba The Iowa Clinic

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1346233178
  Medicare reassignment Care Compare group NPD
• The Iowa Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • West Des Moines, IA
  • NPI 1871451328
  NPD

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1952001505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE TALLGRASS LN STE 220",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502636817",
            "telephone_number": "515-875-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDAL",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A173477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephaniefardal@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1025 SE Tallgrass Ln Ste 220",
            "city": "Waukee",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502636817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela R Ertl, PT
• Eyeq Eyecare and Eyewear PLLC
• Fambul Care LLC
• Familya, LLC (Familya Therapy Services)
• Ikra Farah
• Joseph S Ferezy, D.C.
• Kendra Ferguson, PTA
• Jessica Marie Finken, NP-C
• Jennifer Fisher, M.S.
• Brandon Flores, DC

• Nurse Practitioner in Waukee, IA
• Providers in Waukee, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.