Stephen Glenn Vance, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

051723 Issued in CT

Practice address

21 Montauk Ave
New London, CT 06320-4906

Phone

(860) 439-6400

Fax

(860) 271-4797

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Psychiatry

Education

Louisville Medical College, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Community Health Clinic IncGroup PAC ID 6305755455, shared by 6 NPIs, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: svance335507@direct.ochin.org

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.

• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1497961106
  Medicare reassignment NPD
• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1356714646
  NPD
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)
• University Psychiatric Foundation, Inc.

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457539140
  NPD (past)
• University Psychiatric Services, PSC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1881666949
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1215909379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063200390",
            "telephone_number": "860-271-4700",
            "fax_number": "860-271-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-439-6400",
            "fax_number": "860-271-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "STEPHEN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "051723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200821230",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64076672",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• US Coast Guard Finance Center
• V G Gautam MD PC
• Ciel Valido, BS, RT
• Amanda Lucia Vallario
• Emily Isabella Vanase, BSW
• Jaimi Vann, LPC
• Patrick Vanzile
• Jean Paul Dennis Vargas, IDC
• Marie Vargo, LCSW
• Jeanine Vaughn, LMFT

• Psychiatry Physician in New London, CT
• Providers in New London, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.