Individual provider Active NPI

Stephen B Noe, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1689879405
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA788 Issued in KY
Practice address
95 Bryan Blvd
Ste 201
Corbin, KY 40701-2788
Phone
(606) 526-4590
Fax
(606) 526-0548
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA788 KY Primary

Addresses

Primary practice location

95 Bryan Blvd
Ste 201
Corbin, KY 40701-2788

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (502) 489-5730

Other identifiers 1

IdentifierTypeStateIssuer
PA788OtherKYPA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000901 SC Practitioner - Physician Assistant 3274714902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (843) 847-4559

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 847-4559

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4059SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group, Inc. Physician Assistant Past Accepting new patients

Organizations & group practices 2

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.

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1689879405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BRYAN BLVD",
            "address_2": "STE 201",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012788",
            "telephone_number": "606-526-4590",
            "fax_number": "606-526-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOE",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA788",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.