Mary Lou Stevens, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2119 Issued in CO

Practice address

750 Wellington Ave
Grand Junction, CO 81501-6132

Phone

(970) 244-2457

Fax

(970) 255-1809

NPI assigned

Dec 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, MP2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St. Mary's Regional Hospital Hospital, Grand Junction, CO, CCN 060023

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment Care Compare group
• Commonwealth Healthcare Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saipan, MP
  • NPI 1285858290
  Medicare reassignment NPD
• Intermountain Medical Group Grand Junction, LLC

  dba DME - Wellington Neurosurgery Clinic

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba Western Colorado Obesity Management Clinic

  • Obesity Medicine (Internal Medicine) Physician
  • Grand Junction, CO
  • NPI 1770196917
  NPD
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary's Hospital and Medical Center, Inc

  dba St Mary's CareFlight

  • Ambulance
  • Grand Junction, CO
  • NPI 1164060877

  Hospital

  Care Compare affiliation
• St Mary's Hospital and Medical Center, Inc

  dba St Mary's Anticoagulation Clinic

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  Care Compare affiliation
• St Mary's Hospital and Medical Center, Inc

  dba St Mary's Hospital & Medical Center Life Center OT/PT/SP

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1821647801
  Care Compare affiliation
• St. Mary's Hospital and Medical Center, Inc.

  dba Intermountain Health St Mary's Regional Hospital

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1699716027
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1114903168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815020062",
            "telephone_number": "970-244-7050",
            "fax_number": "970-255-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-244-2457",
            "fax_number": "970-255-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MARY",
        "middle_name": "LOU",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88500268",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxwell Edward Stephens, DO
• Christine Marie Stephenson, LPC
• Deborah Jo Stetler, M.D.
• Samuel Wayne Steury, M.D.
• Steven L Peterson Professional LLC
• Michael G Stevenson, CNA
• Stewart Surgical Associates
• Erica Stewart, OTR/L
• Jared Stewart
• Ronald M Stewart, MD

• Physician Assistant in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.

Verify at the official NPI Registry.