NPIMap

Organization Active NPI

Stevenson Podiatry LLC

  • Podiatrist
  • Halethorpe, MD
National Provider Identifier
1255895512
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
STEVENSON PODIATRY LLC
Doing business as
Stevenson Podiatry LLC
Practice address
4000 Annapolis Rd Rear 105
Halethorpe, MD 21227-3611
Phone
(410) 355-3519
Fax
(410) 355-4643
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Dr. Claymon A. Stevenson II, DPMNPI 1811996739
Title
Owner
Phone
(410) 440-7387

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

4000 Annapolis Rd Rear 105
Halethorpe, MD 21227-3611

Mailing address

8039 Solley Rd
Glen Burnie, MD 21060-8610
Phone (410) 440-7387

Other identifiers 1

IdentifierTypeStateIssuer
1811996739MedicaidMD

Other names 1

  • Stevenson Podiatry LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429000866 MD Part B Supplier - Clinic/Group Practice 9032635487 Receives reassigned benefits from 1 practitioner
Practice locations: Halethorpe, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1255895512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8039 SOLLEY RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608610",
            "telephone_number": "410-440-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 ANNAPOLIS RD REAR 105",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212273611",
            "telephone_number": "410-355-3519",
            "fax_number": "410-355-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENSON PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "CLAYMON",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-440-7387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811996739",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevenson Podiatry LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Halethorpe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.