Active NPI
Erin Stephenson
- Specialist
- Fairfax, VA
National Provider Identifier
1588066096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT010000434
- Practice address
- 12881 Fair Valley CT
Fairfax, VA 22033-3816 - Phone
- (901) 237-8233
- NPI assigned
- Sep 16, 2014
- Last updated
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OT010000434 | DC | Primary |
Addresses
Primary practice location
12881 Fair Valley CT
Fairfax, VA 22033-3816
Mailing address
12881 Fair Valley CT
Fairfax, VA 22033-3816
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT010000434 | DC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1588066096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12881 FAIR VALLEY CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220333816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12881 FAIR VALLEY CT",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220333816",
"telephone_number": "901-237-8233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "ERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "DC",
"license": "OT010000434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.