Kenneth Stevens, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A102905 Issued in CA

Practice address

3268 Waterstone Ave
Henderson, NV 89044-1867

Phone

(815) 378-8514

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14645/brand/1/csg/1/fhir/r4

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.

• Premier Vein Care

  • Phlebology Physician
  • Henderson, NV
  • NPI 1720391527

  CA

  Medicare reassignment NPD Authorized official
• Kenneth Stevens MD Inc a Medical Corporation

  dba Premier Heart Care Inc

  • Cardiovascular Disease Physician
  • Henderson, NV
  • NPI 1265606081
  Authorized official Same address or phone
• Rockford Cardiology Associates, LTD

  • Cardiovascular Disease Physician
  • Rockford, IL
  • NPI 1699775775
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1184643629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3268 WATERSTONE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441867",
            "telephone_number": "815-378-8514",
            "fax_number": "805-540-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3268 WATERSTONE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441867",
            "telephone_number": "815-378-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CA",
            "license": "A102905",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A102905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD LICENSE",
            "identifier": "A102905",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "9136184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "0A1029050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Olenchak, PC (Pain Center of Henderson)
• Steven Paul Winkler M D (Desert Preventative and Diagnostic Medicine)
• Stevens Healthcare LLC
• Brenda Stevens
• Karen Stevens
• Michelle Rhnea Stevens
• Porche Stevens
• Alexandra June Stevenson
• Alexis Stevenson
• Anita Faye Stevenson

• Cardiovascular Disease Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Cardiovascular Disease Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.