Kristin Brook Stevens, OB GYN, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

F360284-1 Issued in NY

Practice address

404 N Cayuga Street
Ithaca, NY 14850-4219

Phone

(607) 277-0969

Fax

(607) 277-3242

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1245255454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N CAYUGA STREET",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504219",
            "telephone_number": "607-277-0969",
            "fax_number": "607-277-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N CAYUGA STREET",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504219",
            "telephone_number": "607-277-0969",
            "fax_number": "607-277-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KRISTIN",
        "middle_name": "BROOK",
        "name_prefix": "Ms.",
        "credential": "OB GYN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F360284-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 438468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02781744",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "AA1307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Stein, D.C.
• Calyx Steiner, LMSW
• Diana Marie Stephens, MD
• Isabella Sterling
• Radomir D Stevanovic, MD
• Denise Karis Stevenson, LPN
• Nancy B Stewart, MD
• Sandra Louise Stewart
• Angelina Rae Stillions, LMT
• Annie Rose Stiver, LMT

• Obstetrics & Gynecology Nurse Practitioner in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Obstetrics & Gynecology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.