NPIMap

Individual provider Active NPI

Johnna Hicks Stevens, M.D.

  • Internal Medicine Physician
  • Bluffton, SC
National Provider Identifier
1184973109
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
81571 Issued in SC
Practice address
Beaufort Memorial Bluffton Primary Care
11 Arley Way, Ste 201
Bluffton, SC 29910-4883
Phone
(843) 706-8690
Fax
(844) 295-9802
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 78307 GA
Internal Medicine Physician 207R00000X 81571 SC Primary

Addresses

Primary practice location

Beaufort Memorial Bluffton Primary Care
11 Arley Way, Ste 201
Bluffton, SC 29910-4883

Mailing address

955 Ribaut Rd
Bmac Credentialing
Beaufort, SC 29902-5441
Phone (843) 522-7843

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Other identifiers 2

IdentifierTypeStateIssuer
81571OtherSCSTATE LICENSE BOARD
815719MedicaidSC

Other names 1

  • Johnna Renee Hicks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20181113003138 SC Practitioner - Internal Medicine 5395040992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaufort County Memorial HospitalGroup PAC ID 7810809365, shared by 11 NPIs, 197 clinicians

Practice addresses (Care Compare)

300 Midtown Dr
Beaufort, SC 29906-5200
Phone (843) 770-0404

Hospital & facility affiliations

  • Amedisys Home Health of Bluffton Home health agency, Bluffton, SC, CCN 427048
  • Aveanna Home Health Home health agency, Hardeeville, SC, CCN 427863
  • Pruitthealth Home Health-Low Country Home health agency, Bluffton, SC, CCN 427123
  • Centerwell Home Health Home health agency, Walterboro, SC, CCN 427856
  • Agape Hospice of the Lowcountry Hospice, North Charleston, SC, CCN 421592
  • Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067
  • Novant Health Hilton Head Medical Center Hospital, Hilton Head Island, SC, CCN 420080
  • Coastal Carolina Hospital Hospital, Hardeeville, SC, CCN 420101
  • Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
83.15
Promoting interoperability
100
Improvement activities
40
Cost
73.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78307GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Sep 1, 2018 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Sep 1, 2018 Accepting new patients
Beaufort County Memorial Hospital Internal Medicine Current Accepting new patients
Beaufort County Memorial Hospital CurrentSince Sep 1, 2018 Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients

Locations

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746

955 Ribaut Rd
#C
Beaufort, SC 29902

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

11 Arley Way
Ste 201
Bluffton, SC 29910
Phone (843) 706-8690

122 Okatie Center Blvd N
Ste 310
Okatie, SC 29909
Phone (843) 706-8690

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

Interoperability endpoints

  • Direct secure messaging: johnna.stevens.1@16436.direct.athenahealth.com

Organizations & group practices 6

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 11

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1184973109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RIBAUT RD",
            "address_2": "BMAC CREDENTIALING",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "843-522-7843",
            "fax_number": "843-522-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEAUFORT MEMORIAL BLUFFTON PRIMARY CARE",
            "address_2": "11 ARLEY WAY, STE 201",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104883",
            "telephone_number": "843-706-8690",
            "fax_number": "844-295-9802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JOHNNA",
        "middle_name": "HICKS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "78307",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "81571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE BOARD",
            "identifier": "81571",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "815719",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNA",
            "last_name": "HICKS",
            "middle_name": "RENEE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.