Shane Stephens

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

24695 Issued in TN

Practice address

701 Med Tech Pkwy
Johnson City, TN 37604-2365

Phone

(423) 302-3480

Fax

(423) 833-0639

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, IA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sstephens112343@balladhealth.medalliesdirect.net

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.

• Medpsych Inc. PC

  • Specialist
  • Kingsport, TN
  • NPI 1962828137
  Medicare reassignment NPD
• SBH-Kingsport

  • Psychiatric Hospital
  • Kingsport, TN
  • NPI 1174038749
  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment NPD
• SBH-Davenport, LLC

  • Adult Mental Health Clinic/Center
  • Bettendorf, IA
  • NPI 1023817475
  Medicare reassignment NPD
• SBH-Kingsport

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1801682299
  NPD
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1760405849
  NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• SBH-Davenport, LLC

  • Psychiatric Hospital
  • Bettendorf, IA
  • NPI 1831720556
  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1285117606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7032 ROBINETTE VALLEY RD",
            "city": "DUFFIELD",
            "state": "VA",
            "postal_code": "242442979",
            "telephone_number": "828-551-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042365",
            "telephone_number": "423-302-3480",
            "fax_number": "423-833-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Executive Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604620",
            "country_code": "US",
            "telephone_number": "833-370-7433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "24695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Leighann Steffey, PA
• Stephen C Steffey, PA
• Step One Medical Associates PC
• Caleb Stephens, PA-C
• Caroline Derrick Stephens, PA
• Tedd A Stephens, EDD
• Page S Sterling, APRN
• Amanda Brooke Stevens, FNP
• Larry Michael Stevens II, APN
• William Stevens

• Psychiatric/Mental Health Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.