Active NPI
Susan M Stevenson, MD
- Pediatrics Physician
- Dallas, TX
National Provider Identifier
1386619435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G4212
- Practice address
- 6847 Kenwhite Dr
Dallas, TX 75231-5611 - Phone
- (214) 334-2889
- NPI assigned
- Feb 22, 2006
- Last updated
- Jan 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G4212 | TX | Primary |
Addresses
Primary practice location
6847 Kenwhite Dr
Dallas, TX 75231-5611
Mailing address
6847 Kenwhite Dr
Dallas, TX 75231-5611
Phone (214) 334-2889
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G4212 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1386619435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6847 KENWHITE DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752315611",
"telephone_number": "214-334-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6847 KENWHITE DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752315611",
"telephone_number": "214-334-2889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-22",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "G4212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.