Christodulos Stefanatos Stavens, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

24509 Issued in KY

Practice address

100 Mallard Creek Rd
Suite 150
Louisville, KY 40207-4194

Phone

(502) 589-7907

Fax

(502) 589-1319

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology, Interventional Cardiology

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pikeville Medical Center Hospital, Pikeville, KY, CCN 180044
• University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clstavens@yourcarecommunity.org

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.

• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment Care Compare group NPD
• Norton Clark Physician Practices, LLC

  • Internal Medicine Physician
  • Clarksville, IN
  • NPI 1083098651

  Cardiovascular Disease, KY

  Medicare reassignment NPD
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD
• Nephrology Associates of Kentuckiana PSC

  • Nephrology Physician
  • Louisville, KY
  • NPI 1730161753
  NPD (past)
• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  NPD (past)
• Pikeville Medical Center Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Whitesburg, KY
  • NPI 1871575498
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Norton Clark Physician Practices, LLC

  • Urgent Care Clinic/Center
  • Sellersburg, IN
  • NPI 1063896637
  NPD (past)

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

• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  Care Compare affiliation
• University of Kentucky

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1518911338
  Care Compare affiliation

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1659457232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 150",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074194",
            "telephone_number": "502-589-7907",
            "fax_number": "502-589-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 150",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074194",
            "telephone_number": "502-589-7907",
            "fax_number": "502-589-1319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Bypass Rd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415011602",
            "country_code": "US",
            "telephone_number": "606-430-2201",
            "fax_number": "606-218-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVENS",
        "first_name": "CHRISTODULOS",
        "middle_name": "STEFANATOS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01035475A",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "KY",
            "license": "24509",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "24509",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "24509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1052057",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64245095",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000052133",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060052924",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/MADISON",
            "identifier": "060053877",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "687915",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200040930",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "25-00167",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG PROGRA",
            "identifier": "299856",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO HEALTH PLAN",
            "identifier": "415633P",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAL MEDICARE/TVILLE",
            "identifier": "060052921",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Fowler Stauble, LPCC
• Taylor Stauble, MS, RD, LD
• Joshua Stauffer
• Lauren Eileen Stauffer
• Erin Stautberg, MS, CCC-SLP
• Gerasimos S Stavens, MD
• Kaniktra Steadmon, BSW, LSW
• Jillian Jean-Anne Stearman, M.D.
• Kellie Stearman
• Brittany Stearns, PTA

• Cardiovascular Disease Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Cardiovascular Disease Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.
• 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.