Susan M. Stevens, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1216 Issued in ME

Practice address

180 Kennedy Memorial Drive
Suite 303
Waterville, ME 04901

Phone

(207) 872-5952

Fax

(207) 873-2952

NPI assigned

Aug 7, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Redington-Fairview General Hospital

  • Rural Health Clinic/Center
  • Madison, ME
  • NPI 1851423008

  Family Medicine

  NPD (past)
• Sunbury Primary Care, P.a.

  • Family Medicine Physician
  • Bangor, ME
  • NPI 1508939398
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1477562593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 KENNEDY MEMORIAL DRIVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-861-3338",
            "fax_number": "207-861-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DRIVE",
            "address_2": "SUITE 303",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-872-5952",
            "fax_number": "207-873-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281090099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000937",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "E16132",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1044339",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDNET",
            "identifier": "010474554",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M56781",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Stetkis, CADC
• Michael Stetson, LCPC-C
• Carla Jane Stevens, COTA/L
• Jennifer Louise Stevens, LCSW
• Jeri W Stevens, PH.D., LCPC
• Cameron Stewart
• Dale Stewart
• Isaac Matthew Stone, RN
• Jeffrey A Stone, D.O.
• Sally S Stothoff, FNP

• Family Medicine Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.