Individual provider Active NPI

Kathleen Shirley Stern, M.D.

  • Ophthalmology Physician
  • Memphis, TN
National Provider Identifier
1275842197
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35.087439 Issued in OH
Practice address
655 S Riverside Dr Apt 1103
Memphis, TN 38103-4615
Phone
(706) 564-4308
NPI assigned
Sep 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35.087439 OH Primary

Addresses

Primary practice location

655 S Riverside Dr Apt 1103
Memphis, TN 38103-4615

Mailing address

655 S Riverside Dr Apt 1103
Memphis, TN 38103-4615
Phone (706) 564-4308

Other practice location 1

440 Whitman Ct
Cincinnati, OH 45202-1871
Phone (706) 564-4308

Other practice location 2

6630 Summer Knoll Cir Ste 101
Bartlett, TN 38134
Phone (901) 746-9438

Other practice location 3

6630 Summer Knoll Cir Ste 101
Bartlett, TN 38134
Phone (901) 746-9438

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.087439OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgeon PC Ophthalmology Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1275842197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S RIVERSIDE DR APT 1103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034615",
            "telephone_number": "706-564-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S RIVERSIDE DR APT 1103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034615",
            "telephone_number": "706-564-4308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Whitman Ct",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452021871",
            "country_code": "US",
            "telephone_number": "706-564-4308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6630 Summer Knoll Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "38134",
            "country_code": "US",
            "telephone_number": "901-746-9438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6630 Summer Knoll Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "38134",
            "country_code": "US",
            "telephone_number": "901-746-9438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STERN",
        "first_name": "KATHLEEN",
        "middle_name": "SHIRLEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.087439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.