Sharisse Marie Stephenson, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

01090219A Issued in IN

Practice address

583 S Clarizz Blvd
Bloomington, IN 47401-5515

Phone

(812) 676-4460

Fax

(812) 355-4092

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sstephenson821349@direct.centracare.com
• Direct secure messaging: sstephenso1@direct.iuhealth.org
• FHIR API: https://api.platform.athenahealth.com/7875/brand/1/csg/1/fhir/r4
• Direct secure messaging: sharisse.stephenson.1@7875.direct.athenahealth.com
• Direct secure messaging: sstephenson@direct.iuhealth.org

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.

• Neurological Associates of North Texas

  • Neurological Surgery Physician
  • Dallas, TX
  • NPI 1619399706
  Medicare reassignment NPD Authorized official
• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1629637475

  Neurology

  Medicare reassignment NPD
• North Texas Neurological Associates

  • Neurology Physician
  • Mesquite, TX
  • NPI 1073521027
  Medicare reassignment NPD
• Neurological Associates of North Texas

  • Neurology Physician
  • Rowlett, TX
  • NPI 1699166025
  NPD (past) Authorized official
• Neurological Associates of North Texas PLLC

  • Neurology Physician
  • Dallas, TX
  • NPI 1841627767
  NPD (past) Authorized official
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  NPD
• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Franklin, VA
  • NPI 1205451028
  NPD
• Brainhertz Neurodiagnostic LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Desoto, TX
  • NPI 1043763493
  NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1538358684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 S CLARIZZ BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015515",
            "telephone_number": "812-676-4460",
            "fax_number": "812-355-4092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10611 Garland Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752184806",
            "country_code": "US",
            "telephone_number": "214-324-9301",
            "fax_number": "214-324-9305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "SHARISSE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "233320",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101281179",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01090219A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "090540887",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300078531",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstephenson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "583 S Clarizz Blvd",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474015515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karl D Steinke, DO
• Jennifer Steinmetz, MSW, LCSW, LLC
• Stephanie Turpin, LLC
• Hannah Stephens
• Kathleen A Stephens, MSW LCSW
• Zenda Stephenson
• Gary Bradley Stepp, PSY.D.
• Stepping Stones, Inc.
• Lauren Theresa Steury, MS, CCC-SLP
• David J. Stevens, MD

• Neurology Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.