Active NPI
Nikole Stephens
- Family Medicine Physician
- Saint Cloud, FL
National Provider Identifier
1134583404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS14906
- Practice address
- 3100 17TH St
Saint Cloud, FL 34769-6021 - Phone
- (407) 892-0009
- Fax
- (407) 892-3285
- NPI assigned
- Apr 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | OS14906 | FL | Primary |
Addresses
Primary practice location
3100 17TH St
Saint Cloud, FL 34769-6021
Mailing address
3100 17TH St
Saint Cloud, FL 34769-6021
Phone (407) 892-0009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS14906 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1134583404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 17TH ST",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347696021",
"telephone_number": "407-892-0009",
"fax_number": "407-892-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 17TH ST",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347696021",
"telephone_number": "407-892-0009",
"fax_number": "407-892-3285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "NIKOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2020-12-11",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS14906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.