Active NPI
Branden Stephens, ACT
- Plastic Surgery Physician
- Columbia, MO
National Provider Identifier
1144880337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 2013029731
- Practice address
- 100 Matc
Columbia, MO 65203 - Phone
- (573) 882-6501
- NPI assigned
- Jun 19, 2019
- 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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 2013029731 | MO | Primary |
Addresses
Primary practice location
100 Matc
Columbia, MO 65203
Mailing address
100 Matc
Columbia, MO 65203
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013029731 | MO | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560902400000",
"number": "1144880337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MATC",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MATC",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65203",
"telephone_number": "573-882-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "BRANDEN",
"name_prefix": "Mr.",
"credential": "ACT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-19",
"last_updated": "2019-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MO",
"license": "2013029731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.