Phillip John Stephan, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

L2679 Issued in TX

Practice address

2200 Kell Blvd
Wichita Falls, TX 76309-4401

Phone

(940) 264-2600

Fax

(940) 264-2601

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Plastic and Reconstructive Surgery

Education

University of Texas Southwestern Medical School at Dallas, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Regional Health Care System Hospital, Wichita Falls, TX, CCN 450010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
• Direct secure messaging: pstephan14769@unitedregional.medalliesdirect.net
• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Texoma Plastic Surgery, P.a.

  • Plastic Surgery Physician
  • Wichita Falls, TX
  • NPI 1578882809
  Medicare reassignment NPD Authorized official
• Texoma Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Wichita Falls, TX
  • NPI 1740671429
  NPD (past) Authorized official
• United Regional Health Care System Inc

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448
  NPD
• John L. Burns, M.D., P.a.

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1962477091

  Plastic Surgery

  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• United Regional Health Care System Inc

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448
  Care Compare affiliation

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1053387399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763071011",
            "telephone_number": "214-522-0210",
            "fax_number": "214-522-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094401",
            "telephone_number": "940-264-2600",
            "fax_number": "940-264-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "PHILLIP",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L2679",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "L2679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Starling, LPT
• Ashley Statham, LPC
• Shane David Statham
• Isaac Sheffield Staton, LPC
• Kayla Steinly
• Stephen E Farmer DO PA
• Michael Stephenson-Pino, IDMT
• Teressa Dawn Stephenson, R.N.
• Michelle Diane Stevens
• Joseph Lee Stevenson

• Plastic Surgery Physician in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.