Seline T Stephen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28963 Issued in KY

Practice address

1101 Grade Lane 123 MDS
Tricare Family Practice
Louisville, KY 40213

Phone

(502) 364-9635

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598878720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 DEER POND CV",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598042",
            "telephone_number": "502-292-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GRADE LANE 123 MDS",
            "address_2": "TRICARE FAMILY PRACTICE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40213",
            "telephone_number": "502-364-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "SELINE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "28963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephclemm Art Therapy LLC
• Stephen Klump Counseling, LLC
• Stephen L Graham DC PSC
• Stephen Pobst DC PLLC
• Sarah Stephen
• Thomas C Stephen, MD
• Stephens Drugs Inc
• Kymora Monika Stephens-Arvin
• Aaron Cody Stephens
• Adrianna Nikole Stephens, RN

• Family Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Medicine Physician in Kentucky

• 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.
• 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.