NPIMap

Individual provider Active NPI

Stephen Leander Cheshire III, PH.D.

  • Prescribing (Medical) Psychologist
  • Los Lunas, NM
National Provider Identifier
1346397387
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
0042 Issued in NM
Practice address
2235 Main St NE
Suite C
Los Lunas, NM 87031
Phone
(505) 916-0820
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY002308 GA
Clinical Psychologist 103TC0700X 1251 NM
Prescribing (Medical) Psychologist 103TP0016X 0042 NM Primary

Addresses

Primary practice location

2235 Main St NE
Suite C
Los Lunas, NM 87031

Mailing address

2235 Main St NE
Suite C
Los Lunas, NM 87031
Phone (505) 916-0820

Other identifiers 2

IdentifierTypeStateIssuer
000896816DMedicaidGA
277711000OtherGAMAGELLAN PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY002308GAMDClinical Psychologist
1251NMMDClinical Psychologist
0042NMMDPrescribing (Medical) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
A New Start Counseling Center Inc Clinical Past Accepting new patients
Accordia Counseling Solutions Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1346397387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 MAIN ST NE",
            "address_2": "SUITE C",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "87031",
            "telephone_number": "505-916-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 MAIN ST NE",
            "address_2": "SUITE C",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "87031",
            "telephone_number": "505-916-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESHIRE",
        "first_name": "STEPHEN",
        "middle_name": "LEANDER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002308",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1251",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "0042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000896816D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER ID",
            "identifier": "277711000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.