Stephen Lavalley, CNP
Individual provider Active NPI Family Nurse Practitioner · Racine, OH
NPI 1508623653 · NPPES record last updated Apr 29, 2024
Key facts
- NPI
- 1508623653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0035841 (OH)
- Practice address
- 207 5TH St
Racine, OH 45771-5012 - Phone
- (740) 949-2683
- Fax
- (740) 949-2462
- NPI assigned
- Mar 5, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ohiohealth Corporation
Practice addresses (Care Compare)
207 5TH St
Racine, OH 45771-5012
Phone (740) 949-2683
Hospital & facility affiliations
- Ohiohealth O'Bleness Hospital
- Holzer Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240406000386 | OH | Practitioner - Nurse Practitioner | 5698113868 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89526 | WV | MD | Registered Nurse |
| 0035841 | OH | MD | Family Nurse Practitioner |
| 118685 | WV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohiohealth Corporation | Current |
Accepting new patients | |
| Ohiohealth Corporation | Current |
Accepting new patients | |
| Ohiohealth Corporation | Current | Accepting new patients |
Locations
393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108
Dept L3652
Columbus, OH 43260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 89526 | WV | |
| Family Nurse Practitioner | 363LF0000X | 118685 | WV | |
| Family Nurse Practitioner | 363LF0000X | 0035841 | OH | Yes |
Addresses
Primary practice location
207 5TH St
Racine, OH 45771-5012
Mailing address
PO Box 7527
Dublin, OH 43017-0727
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | clavalley1070688@direct.ohiohealth.com | OhioHealth Physician Group, Inc. |
Other providers in Racine, OH
- Morgan Raeann Gordon
- Lesley Hayes
- Hopewell Health Centers, Inc.
- Hopewell Health Centers, Inc.
- Douglas D. Hunter
- Heather Lavender
- Margie J Lawson
- Shawna Lemley
- Madison Lisle
- Junetta A Maynard
All providers in Racine, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.