Individual provider Active NPI

Vickie Lynn Stephens, CRNA

  • Certified Registered Nurse Anesthetist
  • Eugene, OR
National Provider Identifier
1710229885
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201803789CRNA Issued in OR
Practice address
920 Country Club Rd Ste 220B
Eugene, OR 97401
Phone
(541) 342-5012
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9316957 FL
Registered Nurse 163W00000X 096007395RN OR
Certified Registered Nurse Anesthetist 367500000X 201803789CRNA OR Primary

Addresses

Primary practice location

920 Country Club Rd Ste 220B
Eugene, OR 97401

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other practice location 1

7111 Fairway Dr Ste 450
Palm Beach Gardens, FL 33418-4200
Phone (561) 799-3552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130625000054 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517106529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians
Parrish Anesthesia Specialist, LLCGroup PAC ID 8921289943, 36 clinicians

Practice addresses (Care Compare)

4500 W Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 367-2310

8300 Red Bug Lake Rd
Oviedo, FL 32765-6801
Phone (407) 359-4503

951 N Washington Ave
Titusville, FL 32796-2163
Phone (321) 268-6111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9316957FLMDRegistered Nurse
096007395RNORMDRegistered Nurse
201803789CRNAORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Parrish Anesthesia Specialist, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2023 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Organizations & group practices 4

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 2

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1710229885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 COUNTRY CLUB RD STE 220B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-342-5012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7111 Fairway Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334184200",
            "country_code": "US",
            "telephone_number": "561-799-3552",
            "fax_number": "561-623-2032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9316957",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "096007395RN",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201803789CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.