John E. Stevenson, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

043914 Issued in MI

Practice address

414 Plymouth Ave NE
Grand Rapids, MI 49505-6038

Phone

(616) 454-3465

Fax

(616) 454-9004

NPI assigned

Oct 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Great Lakes Neurosurgical Associates, PC

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
  • NPI 1306366810
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225119027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056038",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056038",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "043914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1845978",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Stevens, FNP-BC
• Beth Stevenson, NP
• Brenda Stevenson, ACSW, LMSW
• Emily Marie Stevenson, RDN
• Hilary Paige Stevenson, PHD, MD
• Jordan B Stevenson, PA
• Laura Eileen Stevenson, PA-C
• Thomas A Stevenson, D.O.
• Christine Allison Stever, RPH
• Shavonti Steward

• Neurological Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.