Active NPI
John R Stevens, M.S.
- Psychologist
- York, PA
National Provider Identifier
1114096781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004861L
- Practice address
- 2647 Carnegie Rd
York, PA 17402-3786 - Phone
- (717) 755-0921
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS004861L | PA | Primary |
Addresses
Primary practice location
2647 Carnegie Rd
York, PA 17402-3786
Mailing address
2870 Carol Rd
York, PA 17402-3865
Phone (717) 755-0921
Other practice location 1
2870 Carol Rd
York, PA 17402-3865
Phone (717) 755-0921
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01829801 | Other | PA | CAPITAL BLUR CROSS |
| 11626025 | Other | PA | CAQH |
| 447066 | Other | PA | HIGHMARK BLUE SHIELD |
| 0102338000 | Other | PA | MAGELLAN HEALTH SERVICES |
| 442031 | Other | PA | VALUE OPTIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004861L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1114096781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2870 CAROL RD",
"city": "YORK",
"state": "PA",
"postal_code": "174023865",
"telephone_number": "717-755-0921",
"fax_number": "717-751-0783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2647 CARNEGIE RD",
"city": "YORK",
"state": "PA",
"postal_code": "174023786",
"telephone_number": "717-755-0921"
}
],
"practiceLocations": [
{
"address_1": "2870 Carol Rd",
"address_purpose": "LOCATION",
"city": "York",
"state": "PA",
"postal_code": "174023865",
"country_code": "US",
"telephone_number": "717-755-0921",
"fax_number": "717-751-0783",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEVENS",
"first_name": "JOHN",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004861L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUR CROSS",
"identifier": "01829801",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11626025",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "447066",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH SERVICES",
"identifier": "0102338000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "442031",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.