1386668325 NPI number — DR. ANNA MARIKA STONE M.D.

Table of content: DR. ANNA MARIKA STONE M.D. (NPI 1386668325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386668325 NPI number — DR. ANNA MARIKA STONE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STONE
Provider First Name:
ANNA
Provider Middle Name:
MARIKA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386668325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 N 68TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68132-2656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-708-1855
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 NORTHCREST DR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-1698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-328-9605
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP3000X , with the licence number:  01087433A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP3000X , with the licence number: 23934 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207L00000X , with the licence number: MD-43271 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP3000X , with the licence number: MD-43271 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP3000X , with the licence number: 60919 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 252021 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0734061 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G0189393590 . This is a "BLUE CHOICE GROUP ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MDH705 . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7924521 . This is a "AETNA ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CC0135 . This is a "RAILROAD MEDICARE GRP ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2001841 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 699631 . This is a "MVP PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P010222795 . This is a "BLUE CHOICE ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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