Stephen H Jennison, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-091807 Issued in IL

Practice address

619 E Mason St
Suite 4P57
Springfield, IL 62701-1034

Phone

(217) 788-0706

Fax

(217) 525-2535

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Schuyler County Hospital District

  • Critical Access Hospital
  • Rushville, IL
  • NPI 1013969112
  NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1043391766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19420",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949420",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNISON",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-091807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "060031123",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer S Lee MD LLC
• Amy Kathleen Jennings, LCSW
• Emily Jo Jennings, APN
• Gayle Joanne Jennings, R.D.
• Jean M Jennings, CRNA
• Elisa Anne Jensen, MD
• Kayla Jensen, OTR
• Phllip M. Jensen, D.M.D.
• Tabitha Jensen
• Takouhie Araxie Jensen

• Specialist in Springfield, IL
• Providers in Springfield, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.