Individual provider Active NPI

Stephanie Jean Stockburger, M.D.

  • Pediatrics Physician
  • Lexington, KY
National Provider Identifier
1619112596
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44727 Issued in KY
Practice address
Uk Adolescent Medicine
740 South Limestone Street, Kentucky Clinic J-413
Lexington, KY 40536-0284
Phone
(859) 323-5643
Fax
(859) 323-3795
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44727 KY Primary

Addresses

Primary practice location

Uk Adolescent Medicine
740 South Limestone Street, Kentucky Clinic J-413
Lexington, KY 40536-0284

Mailing address

Uk Adolescent Medicine
740 South Limestone Street, Kentucky Clinic J-413
Lexington, KY 40536-0284
Phone (859) 323-5643

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111112000017 KY Practitioner - Pediatric Medicine 3072787878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kentucky College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

100 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 257-9800

2400 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 323-7426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Pediatrics CurrentSince Sep 27, 2011 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Interoperability endpoints

  • Direct secure messaging: sstockburger33206@ukhcdirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1619112596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UK ADOLESCENT MEDICINE",
            "address_2": "740 SOUTH LIMESTONE STREET, KENTUCKY CLINIC J-413",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-5643",
            "fax_number": "859-323-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UK ADOLESCENT MEDICINE",
            "address_2": "740 SOUTH LIMESTONE STREET, KENTUCKY CLINIC J-413",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-5643",
            "fax_number": "859-323-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKBURGER",
        "first_name": "STEPHANIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "44727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.