Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephanie Vermillion, PA-C, ATC

Individual provider Athletic Trainer · NPI 1629464144

Stephanie Vermillion, PA-C, ATC is a Physician Assistant in Phoenix, Arizona. Qualified in 2021, 5 years ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1320 N 10th St Ste B
Phoenix, AZ 85006-2710
Phone: (028) 397-2856
Fax: (602) 839-7272
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7400 N Dobson Rd, Scottsdale, AZ 85256-2736 — (480) 733-7400

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 8761 (AZ)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1629464144
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , ATC
Sole proprietorNo
NPI enumeratedApril 10, 2015
Last updated in NPPESDecember 19, 2023
Certification dateDecember 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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