Shelby A Stephenson, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

24950 Issued in NC

Practice address

1629 Owen Dr
Fayetteville, NC 28304-3425

Phone

(910) 484-2284

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Shelby Stephenson

  • Ophthalmology Physician
  • Fayetteville, NC
  • NPI 1598878571
  NPD (past) Authorized official
• Shelby Stephenson MD

  • Ophthalmology Physician
  • Elizabethtown, NC
  • NPI 1174636849
  NPD (past) Authorized official
• Sessoms Medical Assoicates,LLC

  • Internal Medicine Physician
  • Clinton, NC
  • NPI 1508123571
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1639136229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64363",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283060363",
            "telephone_number": "910-483-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-484-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043416",
            "country_code": "US",
            "telephone_number": "910-483-3534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1726 Metromedical Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043861",
            "country_code": "US",
            "telephone_number": "910-484-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "SHELBY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "24950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180018924",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8979732",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8979731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Stephens, LCSW-A
• Jacqueline Stephens, LMBT
• James F Stephens, MA CCCA
• Jennifer Stephens
• Maria Lynn Stephenson
• Stepping Stones Alternative Services
• Stepping Stones Alternative Services
• Stepping Stones Early Intervention Services LLC
• Stepping Stones Group Homes, Inc.
• Ruth Alizabeth Sterbach

• Ophthalmology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.