Individual provider Active NPI

Stephen Patrick Adkisson, FNP

  • Family Medicine Physician
  • Clinton, NY
National Provider Identifier
1093551178
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51973-01 Issued in NY
Practice address
34 Chenango Ave
Clinton, NY 13323-1399
Phone
(315) 853-5550
NPI assigned
Jul 8, 2024
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51973-01 NY Primary

Addresses

Primary practice location

34 Chenango Ave
Clinton, NY 13323-1399

Mailing address

104 Utica Rd
Clinton, NY 13323-1546
Phone (315) 939-3083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241119001937 NY Practitioner - Nurse Practitioner 2062947732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

34 Chenango Ave
Clinton, NY 13323-1341
Phone (315) 853-5550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51973-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Nov 18, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 18, 2024 Accepting new patients

Locations

34 Chenango Ave
Clinton, NY 13323
Phone (315) 381-3386

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Interoperability endpoints

  • Direct secure messaging: sadkisson559021@bassett.direct-ci.net

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.

Hospital & facility affiliations 2

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1093551178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 UTICA RD",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231546",
            "telephone_number": "315-939-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 CHENANGO AVE",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231399",
            "telephone_number": "315-853-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKISSON",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "51973-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NY

Sources for this page

Verify at the official NPI Registry.