STEPHANIE DALE GUAJARDO (CNP) – Women's Health Nurse Practitioner, NPI 1649425380

STEPHANIE DALE GUAJARDO (CNP) is a healthcare provider. based in Centerville, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. COA10124NP (OH). The NPI Number for STEPHANIE DALE GUAJARDO (CNP) is 1649425380

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE DALE GUAJARDO (CNP)
NPI
1649425380
Phone
(937) 436-9825
Address
7756 WASHINGTON VILLAGE DR
Enumeration Date
21 November 2008
Last Update Date
8 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372987751
Graduation Year
2008 (18 years ago)
PAC ID
9739356122
Group Practice PAC ID
3173710936
Professional Enrollment ID
I20120126000204
Address ID
OH454292405KE4441XAVEX400

Contacts

Secure Messaging
sspahr517113@direct.ketteringhealth.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:17State licenses:2Other namesUpdated within 12 months

14,984 NURSE PRACTITIONER in OH

Provider Addresses for STEPHANIE DALE GUAJARDO (CNP)

  • 7756 WASHINGTON VILLAGE DR

    SUITE 135

    CENTERVILLE, OH 454593999

    Phone: (937) 436-9825

    Fax: (937) 436-4336

    Type: Location

  • 600 W MAIN ST STE 330

    TROY, OH 453733384

    Phone: (937) 429-7350

    Fax: (937) 431-2623

    Type: Location

  • 2110, Leiter Road, Miamisburg, Montgomery County, Ohio, 45342, United States

    MIAMISBURG, OH 453423598

    Phone: (937) 914-7067

    Fax: (937) 522-7513

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120126000204INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 45459)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173710936View full group profile
NameSpecialtyState
Geriatric Medicine, Hematology/OncologyIL
Nurse PractitionerOH
Hematology/Oncology, Internal MedicineOH
Radiation OncologyOH
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Orthopedic SurgeryOH
Pulmonary Disease, Critical Care (Intensivists), Sleep MedicineOH
Physician AssistantOH
Hospitalist, Emergency MedicineOH

Reviews

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Frequently asked questions

Does STEPHANIE DALE GUAJARDO (CNP) have a public NPI I can cite?
Public records show STEPHANIE DALE GUAJARDO (CNP) under NPI 1649425380.
Does the public listing show STEPHANIE DALE GUAJARDO (CNP) as active?
STEPHANIE DALE GUAJARDO (CNP)'s NPI record reflects an active status in NPPES.
What type of care does STEPHANIE DALE GUAJARDO (CNP) provide?
STEPHANIE DALE GUAJARDO (CNP)'s profile centers on Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit STEPHANIE DALE GUAJARDO (CNP) in Centerville, Ohio?
For routing, start with Centerville, Ohio for STEPHANIE DALE GUAJARDO (CNP), then verify phone and hours locally.
Can I export STEPHANIE DALE GUAJARDO (CNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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