Individual provider Active NPI

Carmen Michelle Stephenson, NP

  • Acute Care Nurse Practitioner
  • Portsmouth, VA
National Provider Identifier
1053139907
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024192104 Issued in VA
Practice address
3640 High St Ste 2E
Portsmouth, VA 23707-3213
Phone
(757) 215-3565
Fax
(757) 397-8026
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024192104 VA Primary
Acute Care Nurse Practitioner 363LA2100X 1168767 TX

Addresses

Primary practice location

3640 High St Ste 2E
Portsmouth, VA 23707-3213

Mailing address

PO Box 639971
Cincinnati, OH 45263-9971

Other practice location 1

600 Gresham Dr Fl 5
Norfolk, VA 23507-1904
Phone (757) 388-3198

Other practice location 2

10611 Garland Rd Ste 201
Dallas, TX 75218-4806
Phone (214) 324-9301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250901000161 VA Practitioner - Nurse Practitioner 3072014901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 W Jefferson St
Louisville, KY 40202-2881

824 N Military Hwy
Suite 100
Norfolk, VA 23502-3652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1168767TXMDAcute Care Nurse Practitioner
0024192104VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC PastSince Feb 2, 2025 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

824 N Military Hwy
Ste 100
Norfolk, VA 23502
Phone (888) 236-2263

600 Gresham Dr
Fl 5
Norfolk, VA 23507
Phone (757) 388-3198

Interoperability endpoints

  • Direct secure messaging: cstephenson1072983@direct.sentara.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1053139907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639971",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 HIGH ST STE 2E",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073213",
            "telephone_number": "757-215-3565",
            "fax_number": "757-397-8026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Gresham Dr Fl 5",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-3198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10611 Garland Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752184806",
            "country_code": "US",
            "telephone_number": "214-324-9301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "CARMEN",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024192104",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1168767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.