Stephens Memorial Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10189 Issued in FL

Legal business name

STEPHENS MEMORIAL HOME

Practice address

5805 Datil Pepper Rd
Saint Augustine, FL 32086-5699

Phone

(904) 797-0294

Fax

(904) 797-6372

NPI assigned

Apr 26, 2013

Organization subpart

No

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

Authorized official

Name

Brenda Stephens

Title

Owner/Provider

Phone

(904) 797-0294

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1316381890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 DATIL PEPPER RD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865699",
            "telephone_number": "904-797-0294",
            "fax_number": "904-797-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 DATIL PEPPER RD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865699",
            "telephone_number": "904-797-0294",
            "fax_number": "904-797-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENS MEMORIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "904-797-0294"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685603900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Steimle
• Susan Rollo Stein, M.S., R.D., L.D.
• Sharon Lynn Steinmetz, A.R.N.P.
• Stephanie Kinsey DDS (Palencia Dental)
• Stephen Strout, DMD, Ms (St. Augustine Center for Dental Excellence)
• Angela Denise Stephens, LMT
• Cynthia Stephens, CRNA
• Steven R. Freeman DDS PL (Elite Smiles)
• Mary R Steves
• Cameron Alexander Stewart, DC

• Assisted Living Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.