Ubercare, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3908 Issued in AZ

Legal business name

UBERCARE, LLC

Practice address

2440 Hway 95
Suite B
Bullhead City, AZ 86442-7323

Phone

(928) 704-7284

NPI assigned

Aug 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Robert Stephan, D.O.

Title

President

Phone

(928) 704-7284

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1275880288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 HWAY 95",
            "address_2": "SUITE B",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427323",
            "telephone_number": "928-704-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 HWAY 95",
            "address_2": "SUITE B",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427323",
            "telephone_number": "928-704-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UBERCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "STEPHAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-704-7284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803719",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.