Active NPI
Kathryne Wales Stephenson, DNP CPNP
- Pediatrics Physician
- Indianapolis, IN
National Provider Identifier
1093235400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 28177321A
- Practice address
- 8101 Clearvista Pkwy Ste 185
Indianapolis, IN 46256-5605 - Phone
- (317) 621-9000
- NPI assigned
- Jun 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 28177321A | IN | Primary |
Addresses
Primary practice location
8101 Clearvista Pkwy Ste 185
Indianapolis, IN 46256-5605
Mailing address
8101 Clearvista Pkwy
Ste 185
Indianapolis, IN 46256-5605
Phone (317) 621-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
20130 Country Lake Blvd
Noblesville, IN 46062-9327
PO Box
Suite 5299
Tacoma, WA 98415
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
Interoperability endpoints
- kstephenson369285@direct.ochin.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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1730488818
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1093235400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8101 CLEARVISTA PKWY",
"address_2": "STE 185",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462565605",
"telephone_number": "317-621-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8101 CLEARVISTA PKWY STE 185",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462565605",
"telephone_number": "317-621-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "KATHRYNE",
"middle_name": "WALES",
"credential": "DNP CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "28177321A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.