Individual provider Active NPI

Stevan Webster, M.D.

  • Cardiovascular Disease Physician
  • Madison, MS
National Provider Identifier
1184603011
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
10101 Issued in MS
Practice address
216 Kingsbridge Rd
Madison, MS 39110-8485
Phone
(601) 862-7660
NPI assigned
Jan 10, 2006
Last updated
Apr 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10101 MS Primary

Addresses

Primary practice location

216 Kingsbridge Rd
Madison, MS 39110-8485

Mailing address

216 Kingsbridge Rd
Madison, MS 39110-8485
Phone (601) 862-7660

Other identifiers 1

IdentifierTypeStateIssuer
200307120MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070511000605 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1658393178 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crossgates Hma Medical Group, LLC CurrentSince Apr 1, 2010 Accepting new patients
River Oaks Management Company, LLC CurrentSince Mar 1, 2009 Accepting new patients
Crossgates Hma Medical Group LLC Cardiovascular Disease Current Accepting new patients
Crossgates Hma Medical Group, LLC CurrentSince Apr 1, 2010 Accepting new patients
Reservoir Family Medical Clinic, PA Current Accepting new patients
River Oaks Management Company LLC Current Accepting new patients
Careplus Lakeview Family Medicine CurrentSince Mar 1, 2009 Accepting new patients
Evansville Heart Center, LLC Cardiovascular Disease Past Accepting new patients

Locations

201 N College St
Ste 102
Brandon, MS 39042
Phone (601) 825-3074

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1184603011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 KINGSBRIDGE RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108485",
            "telephone_number": "601-862-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 KINGSBRIDGE RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108485",
            "telephone_number": "601-862-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "STEVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "10101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200307120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.