Individual provider Active NPI

Stephen Taylor Ragan, MD

  • Public Health & General Preventive Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1548416795
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
D0090717 Issued in MD
Practice address
101 Nicolls Rd # Hscl3086
Stony Brook, NY 11794-1511
Phone
(631) 444-3902
NPI assigned
Aug 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X D0090717 MD Primary

Addresses

Primary practice location

101 Nicolls Rd # Hscl3086
Stony Brook, NY 11794-1511

Mailing address

3002 Findley Rd
Kensington, MD 20895-2314
Phone (706) 627-4607

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0090717MDMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1548416795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 FINDLEY RD",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952314",
            "telephone_number": "706-627-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD # HSCL3086",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117941511",
            "telephone_number": "631-444-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGAN",
        "first_name": "STEPHEN",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MD",
            "license": "D0090717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.