Active NPI
Edward S Stevenson, RN
- Registered Nurse
- Orangeburg, SC
National Provider Identifier
1598787277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 39348
- Practice address
- 2319 St Matthews Road
Orangeburg, SC 29118 - Phone
- (803) 536-1571
- Fax
- (803) 536-1463
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 39348 | SC | Primary |
Addresses
Primary practice location
2319 St Matthews Road
Orangeburg, SC 29118
Mailing address
2319 St Matthews Road
Orangeburg, SC 29118
Phone (803) 536-1571
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 413093 | Medicaid | SC |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39348 | SC | MD | Pediatric Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598787277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2319 ST MATTHEWS ROAD",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "29118",
"telephone_number": "803-536-1571",
"fax_number": "803-536-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2319 ST MATTHEWS ROAD",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "29118",
"telephone_number": "803-536-1571",
"fax_number": "803-536-1463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "EDWARD",
"middle_name": "S",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "39348",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "413093",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orangeburg, SC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.