Richard T Stevens, MD, PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

61283271205 Issued in UT

Legal business name

RICHARD T STEVENS, MD, PC

Practice address

169 Springcreek Pkwy
100
Providence, UT 84332-9707

Phone

(435) 752-0330

Fax

(435) 755-0922

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard T Stevens, M.D.

Title

Owner

Phone

(435) 752-0330

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1356374086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843320609",
            "telephone_number": "435-752-0330",
            "fax_number": "435-755-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 SPRINGCREEK PKWY",
            "address_2": "100",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329707",
            "telephone_number": "435-752-0330",
            "fax_number": "435-755-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD T STEVENS, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-752-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "UT",
            "license": "61283271205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "61283271205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.