Carl Wayne Stevens II, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

15762 Issued in MS

Practice address

203 S 12TH Ave
Laurel, MS 39440-4324

Phone

(601) 649-9706

Fax

(601) 649-9708

NPI assigned

Sep 20, 2006

Last updated

May 18, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Louisiana State University School of Medicine in Shreveport, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear,Nose and Throat Surgical Clinic of South Central MsGroup PAC ID 1456444546, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
• Wayne General Hospital Hospital, Waynesboro, MS, CCN 250077

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: entsurgicalsouthcentralms.carlwaynestevens@118786.advancedmd-direct.com

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

• Ear,Nose & Throat Surgical Clinic of South Central Ms

  • Otolaryngology/Facial Plastic Surgery Physician
  • Laurel, MS
  • NPI 1033312772
  Medicare reassignment Care Compare group NPD Authorized official
• Laurel Ear, Nose, and Throat Surgical Clinic

  • Otolaryngology Physician
  • Laurel, MS
  • NPI 1851496905
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  Care Compare affiliation
• Wayne General Hospital

  • General Acute Care Hospital
  • Waynesboro, MS
  • NPI 1679559983
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1336246446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S 12TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404324",
            "telephone_number": "601-649-9706",
            "fax_number": "601-649-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S 12TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404324",
            "telephone_number": "601-649-9706",
            "fax_number": "601-649-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CARL",
        "middle_name": "WAYNE",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "15762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119265",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Sparkman
• Lashundra Shanett Speights, FNP-C
• Thomas Dale Spiers Jr., C.R.N.A.
• Hugh Stancill, MD
• Benjamin Paul Stevens
• Deborah Darlene Stonefield, CFNP
• Beverly Straughn, IDD WAIVER SERVICES
• April Stringer
• Lisa Michelle Stringer, OTR
• Shanna Stringer, PT, DPT

• Otolaryngology Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Otolaryngology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.
• 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.