Individual provider Active NPI

Stephanie Mashae Beaver, CRNP

  • Family Nurse Practitioner
  • Guntersville, AL
National Provider Identifier
1952052631
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-114754 Issued in AL
Practice address
8000 Al Highway 69
Guntersville, AL 35976-7140
Phone
(256) 571-8109
NPI assigned
Jan 13, 2022
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-114754 AL Primary

Addresses

Primary practice location

8000 Al Highway 69
Guntersville, AL 35976-7140

Mailing address

8000 Al Highway 69
Guntersville, AL 35976-7140
Phone (256) 571-8109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220214000536 AL Practitioner - Nurse Practitioner 6305239468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Clinic LLCGroup PAC ID 8628980034, 11 clinicians
Marshall Medical Center NorthGroup PAC ID 3577619873, 18 clinicians

Practice addresses (Care Compare)

2337 Homer Clayton Dr
Guntersville, AL 35976-2205
Phone (256) 582-5131

8000 Al Hwy 69
Guntersville, AL 35976-7140
Phone (256) 571-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.74 of 100Reported as group
Quality
30
Improvement activities
40
Cost
72.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Clinic LLC CurrentSince Jun 26, 2023 Accepting new patients
Marshall Medical Center North CurrentSince Feb 1, 2022 Accepting new patients

Locations

2337 Homer Clayton Dr
Guntersville, AL 35976
Phone (256) 582-5131

8000 AL Highway 69
Guntersville, AL 35976
Phone (256) 571-8000

Organizations & group practices 2

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1952052631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 AL HIGHWAY 69",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359767140",
            "telephone_number": "256-571-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 AL HIGHWAY 69",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359767140",
            "telephone_number": "256-571-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "STEPHANIE",
        "middle_name": "MASHAE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-114754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.