Organization Active NPI

Shannon L. Smith-Stephens, DNP, Aprn-BC, PLLC

  • Family Nurse Practitioner
  • Olive Hill, KY
National Provider Identifier
1225695851
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SHANNON L. SMITH-STEPHENS, DNP, APRN-BC, PLLC
Practice address
6902B Grahn Rd
Olive Hill, KY 41164-8147
Phone
(606) 922-0121
Fax
(606) 548-5019
NPI assigned
May 20, 2019
Last updated
Jul 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Authorized official

Name
Dr. Shannon Leigh Smith-Stephens, DNP, APRN-BCNPI 1215968003
Title
Provider/Supplier
Phone
(606) 286-0440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

6902B Grahn Rd
Olive Hill, KY 41164-8147

Mailing address

6902B Grahn Rd
Olive Hill, KY 41164-8147
Phone (606) 286-0440

Other identifiers 1

IdentifierTypeStateIssuer
1215968003OtherINDIVIDUAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190716001745 KY Part B Supplier - Clinic/Group Practice 5092040840 Receives reassigned benefits from 2 practitioners
Practice locations: Olive Hill, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2168466Shannon L Smith-Stephens, DNP, Aprn-BC, PLLC6902B Grahn Rd, Olive Hill, KY 41164Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19906/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1225695851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6902B GRAHN RD",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411648147",
            "telephone_number": "606-286-0440",
            "fax_number": "606-548-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902B GRAHN RD",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411648147",
            "telephone_number": "606-922-0121",
            "fax_number": "606-548-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON L. SMITH-STEPHENS, DNP, APRN-BC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "SMITH-STEPHENS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "PROVIDER/SUPPLIER",
        "authorized_official_telephone_number": "606-286-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1215968003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Hill, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.