Organization Active NPI

Stephen C Spain

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1689718702
Registry record updated Aug 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STEPHEN C SPAIN
Practice address
5040 Kinsey Dr Ste 300
Tyler, TX 75703-3046
Phone
(903) 561-8300
Fax
(903) 561-8327
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2026

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

Authorized official

Name
Stephen C Spain, MDNPI 1487686309
Title
Owner
Phone
(903) 561-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5040 Kinsey Dr Ste 300
Tyler, TX 75703-3046

Mailing address

1702 Holly Creek Dr
Tyler, TX 75703-0907
Phone (903) 561-8300

Other identifiers 3

IdentifierTypeStateIssuer
010054743OtherRAILROAD MEDICARE
89X859OtherBLUE CROSS
133341103MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1107771Stephen C Spain MD5040 Kinsey Dr Ste 300, Tyler, TX 75703Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory

Locations

455 Rice Rd
Tyler, TX 75703
Phone (903) 509-4327

5040 Kinsey Dr
Ste 300
Tyler, TX 75703
Phone (903) 561-8300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787356800000",
    "number": "1689718702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 HOLLY CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030907",
            "telephone_number": "903-561-8300",
            "fax_number": "903-561-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 KINSEY DR STE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033046",
            "telephone_number": "903-561-8300",
            "fax_number": "903-561-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN C SPAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A",
        "authorized_official_last_name": "SPAIN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-561-8300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010054743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "89X859",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133341103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.