NPIMap

Individual provider Active NPI

Samuel Todd Stephens, MD

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1164519427
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-23282 Issued in KS
Practice address
707 N Emporia St
Wichita, KS 67214-3707
Phone
(316) 858-3460
Fax
(316) 858-3458
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-23282 KS Primary

Addresses

Primary practice location

707 N Emporia St
Wichita, KS 67214-3707

Mailing address

PO Box 1897
Wichita, KS 67201-1897
Phone (316) 291-8131

Other identifiers 1

IdentifierTypeStateIssuer
100145020HMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000508 KS Practitioner - Family Practice 7416983085 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Via Christi Hospitals Wichita IncGroup PAC ID 5799696944, 123 clinicians

Practice addresses (Care Compare)

707 N Emporia St
Wichita, KS 67214-3707
Phone (316) 858-3460

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-23282KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minneola District Hospital NBR 2 CurrentSince Jul 1, 2022 Accepting new patients
Minneola District Hospital NBR 2 Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Minneola District Hospital NBR 2 Current Accepting new patients
Minneola District Hospital NBR 2 Family Medicine Past Accepting new patients
Ashland District Hospital Past Accepting new patients
Via Christi Hospitals Wichita, Inc. Family Medicine Past Accepting new patients
Via Christi Immediate Care, Mother Mary Anne Inc. Past Accepting new patients

Locations

2200 Summerlon Cir
Ste A
Dodge City, KS 67801
Phone (620) 371-7300

212 Main St
Minneola, KS 67865
Phone (620) 885-4202

222 Main St
#97
Minneola, KS 67865
Phone (316) 885-4202

222 Main St
Minneola, KS 67865
Phone (620) 885-4202

Organizations & group practices 11

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.

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1164519427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1897",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672011897",
            "telephone_number": "316-291-8131",
            "fax_number": "316-291-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N EMPORIA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143707",
            "telephone_number": "316-858-3460",
            "fax_number": "316-858-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "SAMUEL",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-23282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100145020H",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.