Individual provider Active NPI

Todd Alan Stevens, CRNA

  • Anesthesiology Physician
  • Winston Salem, NC
National Provider Identifier
1639784093
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
135874 Issued in NC
Practice address
717 Magnolia St
Winston Salem, NC 27103-3514
Phone
(716) 381-0204
NPI assigned
Sep 12, 2020
Last updated
Sep 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 135874 NC Primary

Addresses

Primary practice location

717 Magnolia St
Winston Salem, NC 27103-3514

Mailing address

717 Magnolia St
Winston Salem, NC 27103-3514
Phone (716) 381-0204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201105002096 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698185460 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Wake Forest University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
135874NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 12, 2020 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Greensboro Anesthesia Specialists Inc Anesthesiology CurrentSince Dec 9, 2022 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Feb 1, 2023 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1639784093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 MAGNOLIA ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033514",
            "telephone_number": "716-381-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MAGNOLIA ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033514",
            "telephone_number": "716-381-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TODD",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "135874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.