Active NPI
Cassandra Stephens, MD
- Family Medicine Physician
- Campbellsville, KY
National Provider Identifier
1710983564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 31329
- Practice address
- 70 Ubermonkey LN
Campbellsville, KY 42718-5217 - Phone
- (270) 465-0060
- Fax
- (270) 465-0134
- NPI assigned
- Jun 27, 2005
- Reactivated
- Mar 30, 2006
- Last updated
- Aug 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31329 | KY | Primary |
Addresses
Primary practice location
70 Ubermonkey LN
Campbellsville, KY 42718-5217
Mailing address
70 Ubermonkey LN
Campbellsville, KY 42718-5217
Phone (270) 465-0060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64032014 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040105000009 | KY | Practitioner - Family Practice | 1557260031 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 92.9 of 100
- Quality
- 85.93
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Enterprises, Inc. | Family Medicine | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Stephens' Family Medicine
- Family Medicine Physician
- Campbellsville, KY
- NPI 1033320205
-
dba Family Medical Center
- Family Medicine Physician
- Columbia, KY
- NPI 1730243858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1710983564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 UBERMONKEY LN",
"city": "CAMPBELLSVILLE",
"state": "KY",
"postal_code": "427185217",
"telephone_number": "270-465-0060",
"fax_number": "270-465-0134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 UBERMONKEY LN",
"city": "CAMPBELLSVILLE",
"state": "KY",
"postal_code": "427185217",
"telephone_number": "270-465-0060",
"fax_number": "270-465-0134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "CASSANDRA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-06-27",
"last_updated": "2015-08-03",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "31329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64032014",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Campbellsville, KY
- Jami Taylor Spaw, DMD
- Spring View Physician Practices LLC (Spring View Women's & Children's Clinic - Campbellsville)
- Eric Sprowles, PHARM D
- Sarah Emily Squires, LPCC, LCADC
- Erika Jordan Stallings
- Aaron D Stewart, M.D.
- Sara Elizabeth Stiles, APRN
- John C Stockton
- Margaret Strait, AUD
- Kendra Denise Sublett, MSN, APRN, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.