Kimberly Wood Stevens, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

CT2203 Issued in CT

Practice address

649 Clinton Ave
Bridgeport, CT 06605-1711

Phone

(203) 336-2444

Fax

(203) 336-2422

NPI assigned

Feb 7, 2007

Last updated

May 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1235279381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051711",
            "telephone_number": "203-336-2444",
            "fax_number": "203-336-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051711",
            "telephone_number": "203-336-2444",
            "fax_number": "203-336-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KIMBERLY",
        "middle_name": "WOOD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004095669",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Romalin Stephens, LPN
• Natalie Nicole Stepniak, PA-C
• Thamara Sterling, APRN
• Logan Stern, APRN
• Jacqueline Ivana Stevens, LMSW
• Lauren Alyssa Stevens, DPM
• Stewart C Gross MD (Hand Surgery of Southern Connecticut)
• Kendall Morgan Stewart, PT, DPT
• Tjuana Stewart
• Travata Stewart

• Optometrist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.