Clive Norris Stephenson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1073894 Issued in GA

Practice address

1061 Harmon Ave
Ste 1Do3
Ft Stewart, GA 31314-5674

Phone

(912) 435-6933

Fax

(912) 435-5966

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Sun City Orthopaedic & Hand Surgery Specialists PLLC

  • Orthopaedic Surgery Physician
  • El Paso, TX
  • NPI 1053679464
  Medicare reassignment NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528104817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "STE 1DO3",
            "city": "FT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-6933",
            "fax_number": "912-435-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "STE 1DO3",
            "city": "FT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-6933",
            "fax_number": "912-435-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "CLIVE",
        "middle_name": "NORRIS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1073894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Dee Starrett, OD
• Joshua Paul Stauffer, NURSE PRACTITIONER
• Theresa Tucker Steele, PHD
• Nancy J Steimer, CNM
• Kevin Stephens, RN
• Cynthia Stephenson, D.O.
• Hannalore Stevens
• Theresa Stevens
• Kevin Ricks Stevenson, LMSW-C, BCD
• Amber Nicole Stewart, PT, DPT

• Physician Assistant in Ft Stewart, GA
• Providers in Ft Stewart, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.