Individual provider Active NPI

Jill Marie Stevenson, CNP

  • Adult Health Nurse Practitioner
  • Bluffton, SC
National Provider Identifier
1417200239
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
21773 Issued in SC
Practice address
266 Old River Rd
Bluffton, SC 29909-3952
Phone
(419) 307-0416
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 21773 SC Primary

Addresses

Primary practice location

266 Old River Rd
Bluffton, SC 29909-3952

Mailing address

231 Springside Dr
Suite 205
Akron, OH 44333-4530
Phone (330) 666-9544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21773SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Response Nurse Practitioners, LLC Past Accepting new patients
Geriatric Nurse Practitioners, Inc. 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": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1417200239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 SPRINGSIDE DR",
            "address_2": "SUITE 205",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443334530",
            "telephone_number": "330-666-9544",
            "fax_number": "330-670-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 OLD RIVER RD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299093952",
            "telephone_number": "419-307-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "21773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.