Kelly Marie Stephens, RN, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

19629 Issued in CA

Practice address

2755 Alamo St Ste 101
Simi Valley, CA 93065-1311

Phone

(801) 361-7757

NPI assigned

Mar 11, 2010

Last updated

Feb 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kstephens418681@hisp.ehr.sutterhealth.org

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.

• Regal Medical Group, Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1588748073

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1144543695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 ALAMO ST STE 101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651311",
            "telephone_number": "801-361-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 ALAMO ST STE 101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651311",
            "telephone_number": "801-361-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "19629",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "711642",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144543695",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malcolm Stanislaus, LMFT
• Ashley Stavrinou
• Stayhome Senior Care
• Susan Gaye Stayner, COTA
• Steady Home Health
• Sterling Pharmacy, Inc. (Sterling Pharmacy)
• Sterling Provider Services Inc. (Sterling Physical Therapy and Aquatics)
• Steven Kaminsky DMD & Natasha Yashar DDS
• Stevenson Industries, Inc
• Chad Sticher

• Nurse Practitioner in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.