Kimberly Haviland Stephens, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

634432-1 Issued in NY

Practice address

11476 Ridge Rd
Medina, NY 14103-9635

Phone

(585) 798-8951

NPI assigned

Sep 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1437467792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11476 RIDGE RD",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141039635",
            "telephone_number": "585-798-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11476 RIDGE RD",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141039635",
            "telephone_number": "585-798-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KIMBERLY",
        "middle_name": "HAVILAND",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "634432-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Renee Smith, FNP
• South Carriage
• Dale W Sponaugle, MD
• Kelly Squire
• Marcia Deters Stahl, RPH
• Surinder S. Bath, M.D.P.C.
• Carol Taylor, LPN
• Rei Thomas
• Colleen J Thorpe, ND, LAC
• TND Physical Therapy P.C.

• All providers in Medina, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.