Active NPI
Stephen R Stephenson, MD
- Pediatric Hematology & Oncology Physician
- Des Moines, IA
National Provider Identifier
1508850496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- 35187
- Practice address
- 1215 Pleasant St.
Ste. 306
Des Moines, IA 50309-1453 - Phone
- (515) 241-5926
- Fax
- (515) 241-5127
- NPI assigned
- Sep 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Hematology & Oncology Physician | 2080P0207X | 35187 | IA | Primary |
| Pediatric Hematology & Oncology Physician | 2080P0207X | G31607 | CA |
Addresses
Primary practice location
1215 Pleasant St.
Ste. 306
Des Moines, IA 50309-1453
Mailing address
1215 Pleasant St.
Ste. 306
Des Moines, IA 50309-1453
Phone (515) 241-5926
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508850496 | Medicaid | IA | |
| 175150045 | Other | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G31607 | CA | MD | Pediatric Hematology & Oncology Physician |
| 35187 | IA | MD | Pediatric Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Younker Rehabilitation Therapy Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Ankeny, IA
- NPI 1447797113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1508850496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 PLEASANT ST.",
"address_2": "STE. 306",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091453",
"telephone_number": "515-241-5926",
"fax_number": "515-241-5127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 PLEASANT ST.",
"address_2": "STE. 306",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091453",
"telephone_number": "515-241-5926",
"fax_number": "515-241-5127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "STEPHEN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "IA",
"license": "35187",
"primary": true
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "CA",
"license": "G31607",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508850496",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "175150045",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.