Mark Kerry Stephens, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

14020 Issued in WV

Practice address

130 Goff Mountain Rd
Cross Lanes, WV 25313-1419

Phone

(304) 388-7070

Fax

(304) 388-7075

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1952390239
  NPD (past)
• Integrated Health Care Providers

  • Multi-Specialty Clinic/Center
  • Charleston, WV
  • NPI 1922123587
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1568426591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 GOFF MOUNTAIN RD",
            "address_2": "STE 3",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253136600",
            "telephone_number": "304-388-7782",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GOFF MOUNTAIN RD",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131419",
            "telephone_number": "304-388-7070",
            "fax_number": "304-388-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MARK",
        "middle_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "14020",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "14020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930063432",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070668000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda M Springer, DDS
• Stan Kaczkowski DDS PLLC
• Michele Stanley, O.D.
• Alyssa Starcher, RPH
• John Everett Starcher, DDS
• Megan Stevens
• Tiffany Stevens
• Billie Stone
• Gregory C. Stonestreet, M.D.
• Amy Stratton

• Emergency Medicine Physician in Cross Lanes, WV
• Providers in Cross Lanes, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.