Individual provider Active NPI

John Lynn Stephenson II, D.O.

  • Diagnostic Radiology Physician
  • Farmington Hills, MI
National Provider Identifier
1336361138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101015785 Issued in MI
Practice address
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone
(248) 471-8000
NPI assigned
May 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101015785 MI Primary

Addresses

Primary practice location

28050 Grand River Ave
Farmington Hills, MI 48336-5919

Mailing address

9131 Marie St
Livonia, MI 48150-3317
Phone (734) 560-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20121103000098 MI Practitioner - Diagnostic Radiology 3577736669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Muskegon, PCGroup PAC ID 1355241191, 22 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-3955

1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 728-4948

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.54
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101015785MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Muskegon PC Diagnostic Radiology CurrentSince Aug 20, 2012 Accepting new patients

Locations

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

3535 Park St
Ste 105
Norton Shores, MI 49444
Phone (231) 739-7191

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336361138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 MARIE ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503317",
            "telephone_number": "734-560-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919",
            "telephone_number": "248-471-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JOHN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101015785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.