Individual provider Active NPI

Stephanie Rose Smith, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1972031359
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A133352 Issued in IA
Practice address
1631 Logan Ave
Waterloo, IA 50703
Phone
(319) 833-5381
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A133352 IA Primary

Addresses

Primary practice location

1631 Logan Ave
Waterloo, IA 50703

Mailing address

PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390

Other practice location 1

164 W Dale St
Waterloo, IA 50703-1925
Phone (319) 833-5381

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.smith@cvms.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170623000319 IA Practitioner - Nurse Practitioner 4880962471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1631 Logan Ave
Waterloo, IA 50703-1237
Phone (319) 340-2000

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3886

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

909 W 1St St
Sumner, IA 50674-1203
Phone (319) 222-2750

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110
  • Community Memorial Hospital Medical Center Hospital, Sumner, IA, CCN 161320
  • Waverly Health Center Hospital, Waverly, IA, CCN 161339
  • Grundy County Memorial Hospital Hospital, Grundy Center, IA, CCN 161303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A133352IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Apr 30, 2025 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Cedar Valley Medical Specialists PC PastSince Oct 23, 2022 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

201 E J Ave
Grundy Center, IA 50638
Phone (319) 824-5081

1631 Logan Ave
Waterloo, IA 50703
Phone (319) 232-2630

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

1753 W Ridgeway Ave
Ste 103B
Waterloo, IA 50701
Phone (319) 833-5789

312 9th St SW
Ste 3400
Waverly, IA 50677
Phone (319) 483-4029

Interoperability endpoints

  • Direct secure messaging: ssmith268127@direct.unitypoint.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1972031359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390",
            "fax_number": "319-235-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50703",
            "telephone_number": "319-833-5381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 W Dale St",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507031925",
            "country_code": "US",
            "telephone_number": "319-833-5381",
            "fax_number": "319-833-5386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A133352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.smith@cvms.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "CVMS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1631 Logan Ave",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.