Active NPI
Roy J Stephens Sr.
- Specialist
- Redding, CA
National Provider Identifier
1710087556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 1655 E Cypress Ave Ste 3
Redding, CA 96002-1345 - Phone
- (530) 221-4321
- Fax
- (530) 224-1238
- NPI assigned
- Sep 22, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
1655 E Cypress Ave Ste 3
Redding, CA 96002-1345
Mailing address
9885 Winegar Rd
Redding, CA 96003-8231
Phone (530) 221-4321
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ78397Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1710087556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9885 WINEGAR RD",
"city": "REDDING",
"state": "CA",
"postal_code": "960038231",
"telephone_number": "530-221-4321",
"fax_number": "530-224-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 E CYPRESS AVE STE 3",
"city": "REDDING",
"state": "CA",
"postal_code": "960021345",
"telephone_number": "530-221-4321",
"fax_number": "530-224-1238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "ROY",
"middle_name": "J",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ78397Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.