Individual provider Active NPI

Kayla Shurai Stevens, NP-C

  • Family Nurse Practitioner
  • Douglas, GA
National Provider Identifier
1073158887
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN258031 Issued in GA
Practice address
306 Westside Dr
Douglas, GA 31533-3530
Phone
(912) 383-7826
NPI assigned
Nov 15, 2019
Last updated
Nov 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN258031 GA Primary

Addresses

Primary practice location

306 Westside Dr
Douglas, GA 31533-3530

Mailing address

306 Westside Dr
Douglas, GA 31533-3530
Phone (912) 383-7826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200316001940 GA Practitioner - Nurse Practitioner 2769810241 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN258031GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Internal Medicine P.C. CurrentSince Jan 1, 2020 Accepting new patients
Coffee County Hospitalist Physicians, LLC CurrentSince May 16, 2020 Accepting new patients

Locations

143 Highway 32 Byp
Alma, GA 31510
Phone (912) 632-4417

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

306 Westside Dr
Douglas, GA 31533
Phone (912) 383-7826

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16273/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kayla.stevens.1@16273.direct.athenahealth.com

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1073158887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333530",
            "telephone_number": "912-383-7826",
            "fax_number": "912-383-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333530",
            "telephone_number": "912-383-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KAYLA",
        "middle_name": "SHURAI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN258031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.