Individual provider Active NPI

Stephen W Houseworth, M.D.

  • Orthopaedic Surgery Physician
  • Newport, OR
National Provider Identifier
1053306894
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20176 Issued in MS
Practice address
930 SW Abbey St Ste B
Newport, OR 97365-4820
Phone
(541) 574-7235
NPI assigned
Sep 19, 2005
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD192659 OR
Orthopaedic Surgery Physician 207X00000X 20176 MS Primary

Addresses

Primary practice location

930 SW Abbey St Ste B
Newport, OR 97365-4820

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other practice location 1

2516 Broadmoor Boulevard
Suite 3C
Monroe, LA 71201
Phone (318) 998-4460

Other identifiers 1

IdentifierTypeStateIssuer
1353264MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shouseworth186938@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050812000297 LA Practitioner - Orthopedic Surgery 6002845799 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Group, LLC CurrentSince May 26, 2015 Accepting new patients
Affinity Health Group, LLC Orthopaedic Surgery CurrentSince May 26, 2015 Accepting new patients

Locations

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

2516 Broadmoor Blvd
Ste 3C
Monroe, LA 71201
Phone (318) 807-4743

Interoperability endpoints

  • Direct secure messaging: shouseworth186938@samhealth.direct-ci.com
  • Direct secure messaging: shouseworth44671@direct.southcoast.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1053306894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017319",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST STE B",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-574-7235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2516 Broadmoor Boulevard",
            "address_2": "Suite 3C",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "71201",
            "country_code": "US",
            "telephone_number": "318-998-4460",
            "fax_number": "318-998-4462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUSEWORTH",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD192659",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "20176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1353264",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shouseworth186938@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St Ste B",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.