Individual provider Active NPI

Benjamin Michael Stephens, CRNA

  • Certified Registered Nurse Anesthetist
  • Thomasville, AL
National Provider Identifier
1124227061
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-084033 Issued in AL
Practice address
220 Old Highway 5 N
Thomasville, AL 36784-1812
Phone
(334) 636-1333
NPI assigned
Jul 11, 2007
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-084033 AL Primary

Addresses

Primary practice location

220 Old Highway 5 N
Thomasville, AL 36784-1812

Mailing address

220 Old Highway 5 N
Thomasville, AL 36784-1812
Phone (334) 636-1333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110002714 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981625175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams of Gulf Breeze LLCGroup PAC ID 9537326665, 38 clinicians
Ams Baptist LLCGroup PAC ID 6901099688, 80 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-8478

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-084033ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2015 Accepting new patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2015 Accepting new patients
Vaughan Regional Medical Center LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Vaughan Regional Medical Center LLC Past Accepting new patients

Locations

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Organizations & group practices 4

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 1

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1124227061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 OLD HIGHWAY 5 N",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367841812",
            "telephone_number": "334-636-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 OLD HIGHWAY 5 N",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367841812",
            "telephone_number": "334-636-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-084033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.