Individual provider Active NPI

David Wayne Stephenson, MD

  • Internal Medicine Physician
  • Wildwood, FL
National Provider Identifier
1093983157
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME106525 Issued in FL
Practice address
9202 NW 26TH St
Wildwood, FL 34785-7413
Phone
(352) 812-0579
Fax
(352) 571-4349
NPI assigned
Feb 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME106525 FL Primary

Addresses

Primary practice location

9202 NW 26TH St
Wildwood, FL 34785-7413

Mailing address

9202 NW 26TH St
Wildwood, FL 34785-7413
Phone (352) 812-0579

Other identifiers 1

IdentifierTypeStateIssuer
14F4LOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20110726000234 FL Practitioner - Internal Medicine 6608044243 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asm Rahman MD LLCGroup PAC ID 2668731993, 15 clinicians

Practice addresses (Care Compare)

5050 County Rd
Suite 472
Oxford, FL 34484-3750
Phone (352) 245-6922

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promise Medical Group, PLLC Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Inpatient Care Specialists LLC CurrentSince Sep 30, 2023 Accepting new patients
Ocala Hospitalist Group P a Internal Medicine Past Accepting new patients

Locations

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

5050 County Road 472
Oxford, FL 34484
Phone (352) 245-6922

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1093983157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9202 NW 26TH ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857413",
            "telephone_number": "352-812-0579",
            "fax_number": "352-571-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9202 NW 26TH ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857413",
            "telephone_number": "352-812-0579",
            "fax_number": "352-571-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME106525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14F4L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, FL

Sources for this page

Verify at the official NPI Registry.