NPIMap

Individual provider Active NPI

Jeffrey Stuart Stephenson, MD

  • Sports Medicine (Family Medicine) Physician
  • Louisville, KY
National Provider Identifier
1366617078
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
45055 Issued in KY
Practice address
9880 Angies Way
250
Louisville, KY 40241-2851
Phone
(502) 394-6341
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45055 KY
Sports Medicine (Family Medicine) Physician 207QS0010X 45055 KY Primary

Addresses

Primary practice location

9880 Angies Way
250
Louisville, KY 40241-2851

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5063

Other identifiers 6

IdentifierTypeStateIssuer
767416OtherKYANTHEM- NORTON MEDICAL ASSOCIATES
K043290OtherKYMEDICARE- NMA OBC
201221810MedicaidIN
50039136OtherKYPASSPORT HEALTH- NMA OBC
6222460OtherKYCIGNA- NORTON MEDICAL ASSOCIATES
7100203090MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jstephenson11852@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000125 KY Practitioner - Sports Medicine 1355501495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4950 Norton Healthcare Blvd
Louisville, KY 40241-2847

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45055KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Sports Medicine CurrentSince Jul 1, 2012 Accepting new patients
Community Medical Associates, Inc. Family Medicine Past Accepting new patients

Locations

9880 Angies Way
Ste 250
Louisville, KY 40241
Phone (502) 394-6340

4123 Dutchmans Ln
Ste 401
Louisville, KY 40207
Phone (502) 394-6341

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: jstephenson11852@direct.nortonhealthcare.org

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1366617078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9880 ANGIES WAY",
            "address_2": "250",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412851",
            "telephone_number": "502-394-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JEFFREY",
        "middle_name": "STUART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "45055",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KY",
            "license": "45055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM- NORTON MEDICAL ASSOCIATES",
            "identifier": "767416",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- NMA OBC",
            "identifier": "K043290",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201221810",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH- NMA OBC",
            "identifier": "50039136",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA- NORTON MEDICAL ASSOCIATES",
            "identifier": "6222460",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100203090",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstephenson11852@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "9880 Angies Way",
            "address_2": "250",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402412851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9880 Angies Way",
            "address_2": "250",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402412851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.