Stephen L McKernan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L5835 Issued in TX

Practice address

690 S Loop 336 W Ste 200
Conroe, TX 77304-3320

Phone

(936) 525-3600

Fax

(936) 525-3624

NPI assigned

Jul 20, 2005

Last updated

Jul 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1407855547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043320",
            "telephone_number": "936-525-3600",
            "fax_number": "936-525-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043320",
            "telephone_number": "936-525-3600",
            "fax_number": "936-525-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581258-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158125802",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.shsuphysicians.com",
            "affiliation": "N",
            "endpointDescription": "clinic email",
            "address_1": "690 S Loop 336 W Ste 200",
            "city": "Conroe",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773043320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany McGregor
• Madison Beth McGuire
• Lynn Ann McInnis, PA-C
• Kenzie Kay McKay, DO STUDENT
• Samuel Hathaway McKee, DDS
• Laurel L McKillip, M.D.
• Brittany Lynn McLane
• Erin Rene McLean, FNP-C
• Martin McMichael, CRNA
• Melissa Lee McNeil

• Family Medicine Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.