Active NPI
Stephen E Jefferson, MD
- Pulmonary Disease Physician
- Kalamazoo, MI
National Provider Identifier
1235108390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- SJ040708
- Practice address
- 1535 Gull Rd
Ste 130
Kalamazoo, MI 49048 - Phone
- (269) 345-1161
- Fax
- (269) 345-8076
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | SJ040708 | MI | Primary |
Addresses
Primary practice location
1535 Gull Rd
Ste 130
Kalamazoo, MI 49048
Mailing address
1535 Gull Rd
Ste 130
Kalamazoo, MI 49048
Phone (269) 345-1161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1310080 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SJ040708 | MI | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235108390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1535 GULL RD",
"address_2": "STE 130",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49048",
"telephone_number": "269-345-1161",
"fax_number": "269-345-8076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 GULL RD",
"address_2": "STE 130",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49048",
"telephone_number": "269-345-1161",
"fax_number": "269-345-8076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "STEPHEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MI",
"license": "SJ040708",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1310080",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
- Raechal Jaynes
- Tonya Lynn Jazayeri, SLP
- Kathryn Jean, LMSW
- Laura Jedele, PT, DPT
- Evie Jefferies, LLMSW
- Jeffrey N Hamlin DMD PC
- Jeffrey P. Letzer, DO, PLC. Dba Kalamazoo Hematology & Oncology (Kalamazoo Hematology & Oncology)
- Laura Kathleen Jeffrey, M.S.P.T.
- Richard T Jefson, M.D.
- Brenda Jellies, LMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.