Colleen Kathleen Stephens, MSN, APRN, AGNP,GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP115002 Issued in TX

Practice address

6901 Medical Pkwy
Waco, TX 76712-7910

Phone

(254) 751-4242

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Colleen Stephens-Kelly Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cstephenskelly323622@direct.sw.org

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.

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  • Allen, TX
  • NPI 1285051094

  TX

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1306975909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 MEDICAL PKWY",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127910",
            "telephone_number": "254-751-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4945 Williams Dr",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "TX",
            "postal_code": "786332008",
            "country_code": "US",
            "telephone_number": "512-819-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "COLLEEN",
        "middle_name": "KATHLEEN",
        "credential": "MSN, APRN, AGNP,GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "257249",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP115002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185280801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "STEPHENS-KELLY",
            "credential": "MSN, APRN, AGNP,GNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Charles Steele, MD
• Robert Jason Steele, CRNA
• Stacey-Lynn Friesenhahn Steger, LCSW
• Ann Louise Steinberg, DC
• Pamela Kathryn Stelk, LCDC
• Joyce Geralyn Stephens, MA OTR CHT
• Shealyn Elizabeth Stephens, M.S., LPC
• Stepping Stones Therapy, PLLC
• Sterling Speech and Language Services, LLC
• Sterling Speech and Language Services, LLC

• All providers in Waco, TX
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.