Individual provider Active NPI

Seth L Stephenson

  • Nurse Practitioner
  • Mason, OH
National Provider Identifier
1164778924
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.13574-NP Issued in OH
Practice address
5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone
(513) 770-4212
Fax
(513) 770-4213
NPI assigned
Jul 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.13574-NP OH Primary
Family Nurse Practitioner 363LF0000X COA.13574-NP OH
Family Nurse Practitioner 363LF0000X 3007647 KY

Addresses

Primary practice location

5298 Socialville Foster Rd
Mason, OH 45040-9302

Mailing address

5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone (513) 770-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120919000681 OH Practitioner - Nurse Practitioner 3577711316 Reassigns benefits to 1 organization
I20120920000635 KY Practitioner - Nurse Practitioner 3577711316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Group IncGroup PAC ID 6406740141, 19 clinicians

Practice addresses (Care Compare)

330 Thomas More Pkwy
Crestview Hills, KY 41017-3417
Phone (513) 770-4212

5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone (513) 770-4212

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.13574-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Group, Inc CurrentSince Nov 14, 2016 Accepting new patients

Locations

330 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (513) 241-2360

330 Thomas More Pkwy
Ste 201
Crestview Hills, KY 41017
Phone (853) 934-4621

9403 Kenwood Rd
Ste B100
Blue Ash, OH 45242
Phone (513) 891-8045

4450 Eastgate Blvd
Ste 232
Cincinnati, OH 45245
Phone (513) 752-2247

1 Aviation Way
Cincinnati, OH 45215
Phone (513) 243-2946

6507 Harrison Ave
Unit I
Cincinnati, OH 45247

4000 Smith Rd
Ste 210
Cincinnati, OH 45209

5298 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

36 Remick Blvd
Springboro, OH 45066

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5662/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1164778924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5298 SOCIALVILLE FOSTER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409302",
            "telephone_number": "513-770-4212",
            "fax_number": "513-770-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5298 SOCIALVILLE FOSTER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409302",
            "telephone_number": "513-770-4212",
            "fax_number": "513-770-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "SETH",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.13574-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.13574-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.