Individual provider Active NPI

Stephen George Sigrimis

  • Family Nurse Practitioner
  • London, KY
National Provider Identifier
1255966172
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014239 Issued in KY
Practice address
1102 S Main St
London, KY 40741-1529
Phone
(606) 770-5121
Fax
(606) 770-5199
NPI assigned
Mar 11, 2020
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014239 KY Primary

Addresses

Primary practice location

1102 S Main St
London, KY 40741-1529

Mailing address

1102 S Main St
London, KY 40741-1529
Phone (606) 770-5121

Other identifiers 1

IdentifierTypeStateIssuer
7100864050MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501002780 KY Practitioner - Nurse Practitioner 4981044401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practitioner Services PLLCGroup PAC ID 6305150954, 7 clinicians

Practice addresses (Care Compare)

1102 S Main St
London, KY 40741-1529
Phone (606) 770-6121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3014239KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practitioner Services PLLC Family CurrentSince Mar 19, 2024 Accepting new patients
Practitioner Services PLLC Current Accepting new patients

Locations

1102 S Main St
London, KY 40741
Phone (606) 770-5121

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1255966172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S MAIN ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411529",
            "telephone_number": "606-770-5121",
            "fax_number": "606-770-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S MAIN ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411529",
            "telephone_number": "606-770-5121",
            "fax_number": "606-770-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGRIMIS",
        "first_name": "STEPHEN",
        "middle_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-11",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100864050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.