NPIMap

Individual provider Active NPI

Stephanie Kay Sun, D.O.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • San Angelo, TX
National Provider Identifier
1053550681
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
N1787 Issued in TX
Practice address
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone
(325) 949-9511
NPI assigned
Feb 4, 2009
Last updated
May 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N1787 TX
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X N1787 TX Primary

Addresses

Primary practice location

3501 Knickerbocker Rd
San Angelo, TX 76904-7610

Mailing address

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 949-9511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000149 TX Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 9133301393 Reassigns benefits to 3 organizations
Practice locations: Ft Worth, TX

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Apr 1, 2014 Accepting new patients
Regional Employee Assistance Program Inc Internal Medicine CurrentSince Apr 1, 2014 Accepting new patients
Sutton County Hospital District CurrentSince Nov 1, 2022 Accepting new patients
Regional Employee Assistance Program Inc Internal Medicine Current Accepting new patients
Shannon Clinic Internal Medicine CurrentSince Apr 15, 2021 Accepting new patients
Sutton County Hospital District CurrentSince Nov 1, 2022 Accepting new patients
Concho Hearts Hospice, LLC PastSince Sep 7, 2020 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

308 Hudspeth St
Sonora, TX 76950
Phone (325) 387-2521

Interoperability endpoints

  • Direct secure messaging: ssun42866@shannonhealth.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avir at Meadow CreekSan Angelo, TX, CCN 676031 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2025
May 28, 2020
Regency HouseSan Angelo, TX, CCN 675767 Skilled nursing facility Adp of the SNF Jun 1, 2020
Concho Hearts Hospice, LLCSan Angelo, TX, CCN 971627 Hospice W-2 Managing Employee Sep 7, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1053550681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-949-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-949-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "STEPHANIE",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1787",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "N1787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.