Individual provider Active NPI

Melissa Cassandra Stephenson, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1194282749
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP138382 Issued in TX
Practice address
22202 Bulverde Rd
San Antonio, TX 78261-3080
Phone
(210) 497-0353
NPI assigned
Mar 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138382 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP138382 TX Primary

Addresses

Primary practice location

22202 Bulverde Rd
San Antonio, TX 78261-3080

Mailing address

22202 Bulverde Rd
San Antonio, TX 78261-3080
Phone (210) 497-0353

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Cvs.com Other
CONNECT URL cvs.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210203002063 TX Practitioner - Nurse Practitioner 7517371420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

430 W Sunset Rd
Suite 400
San Antonio, TX 78209-1772
Phone (844) 824-8775

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP138382TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Psychiatric/Mental Health CurrentSince Oct 21, 2024 Accepting new patients
Senior Psychcare of San Antonio I, PLLC Nurse Practitioner CurrentSince Mar 25, 2021 Accepting new patients

Locations

1700 Onion Creek Pkwy
Austin, TX 78748
Phone (512) 291-4900

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

4314 Yoakum Blvd
Houston, TX 77006
Phone 7138500049207

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

5027 Pecan Grove Blvd
San Antonio, TX 78222
Phone (210) 333-6815

222 Bertetti Dr
San Antonio, TX 78227
Phone (210) 673-1700

430 W Sunset Rd
Ste 400
San Antonio, TX 78209
Phone (210) 858-9078

2003 W Hutchins Pl
San Antonio, TX 78224
Phone (210) 927-0800

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.melissastephenson@136732.advancedmd-direct.com

Organizations & group practices 2

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": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1194282749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22202 BULVERDE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613080",
            "telephone_number": "210-497-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22202 BULVERDE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613080",
            "telephone_number": "210-497-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "MELISSA",
        "middle_name": "CASSANDRA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138382",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP138382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cvs.com",
            "affiliation": "N",
            "endpointDescription": "Cvs",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Minute clinic",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "No",
            "address_1": "120 E Sonterra Blvd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782583982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs.com",
            "affiliation": "N",
            "endpointDescription": "cvs",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "minute clinic",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "minute clinic",
            "address_1": "22202 Bulverde Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782613080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.