Morehead State University

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3004857 Issued in KY

Legal business name

MOREHEAD STATE UNIVERSITY

Practice address

112 Allie Young Hall
Morehead, KY 40351-1684

Phone

(606) 783-2885

Fax

(606) 783-9106

NPI assigned

Aug 26, 2011

Organization subpart

Yes

Parent organization

MOREHEAD STATE UNIVERSITYAs reported in NPPES

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

Authorized official

Name

Mrs. Shannon Smith Stephens, DNP, APRN

Title

Director

Phone

(606) 783-2123

Specialties & licenses 8

Addresses

Other identifiers 12

Other names 1

• Morehead State University Counsel & Health Services Doing business as

Part of

Morehead State University

Locations

Practitioners 3

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

• Thomas James Carver, MS, ATC.

  • Athletic Trainer
  • Morehead, KY
  • NPI 1528275831
  NPD (past)
• Richard Fletcher, ATC

  • Athletic Trainer
  • Morehead, KY
  • NPI 1780891085
  NPD (past)
• Katie Fowler, L.P.C.C.

  • Professional Counselor
  • Morehead, KY
  • NPI 1336531367
  NPD (past)

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1689954232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ALLIE YOUNG HALL",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511684",
            "telephone_number": "606-783-2885",
            "fax_number": "606-783-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ALLIE YOUNG HALL",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511684",
            "telephone_number": "606-783-2885",
            "fax_number": "606-783-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOREHEAD STATE UNIVERSITY",
        "enumeration_date": "2011-08-26",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "SMITH STEPHENS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "606-783-2123",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "KY",
            "license": "0668",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03203",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004857",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3796P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002104",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000609845",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000623843",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00754288",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2973242",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K021100",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000231892",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2826311",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100092610",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000298213",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100034230",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78010220",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morehead State University Counsel & Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morehead Pediatric Dentistry, PLLC
• Morehead Pediatrics
• Morehead Pediatrics
• Morehead Peds Dre LLC
• Morehead Primary Care PLLC
• Jasmine Morris
• Jonia Morris
• Kimberly Morris, M.S.,CCC/SLP
• Elizabeth Morton
• Mt Sterling Pediatrics

• Nurse Practitioner in Morehead, KY
• Providers in Morehead, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.