Individual provider Active NPI

Harry Calvin Stephenson, MD

  • Ophthalmology Physician
  • Louisville, KY
National Provider Identifier
1730111717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16047 Issued in KY
Practice address
4001 Kresge Way
Ste. 200
Louisville, KY 40207-4640
Phone
(502) 897-6500
Fax
(502) 897-6599
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16047 KY Primary

Addresses

Primary practice location

4001 Kresge Way
Ste. 200
Louisville, KY 40207-4640

Mailing address

4001 Kresge Way
Ste. 200
Louisville, KY 40207-4640
Phone (502) 897-6500

Other identifiers 1

IdentifierTypeStateIssuer
64160476MedicaidKY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111130000789 KY Practitioner - Ophthalmology 3072547835 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16047KYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Aug 20, 2013 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 20, 2013 Accepting new patients
University of Louisville Physicians, Inc. Ophthalmology Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Louisville, KY 40202
Phone (502) 588-4400

301 E Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 852-0710

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

501 E Broadway
Ste 290
Louisville, KY 40202
Phone (502) 217-5134

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730111717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 KRESGE WAY",
            "address_2": "STE. 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074640",
            "telephone_number": "502-897-6500",
            "fax_number": "502-897-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 KRESGE WAY",
            "address_2": "STE. 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074640",
            "telephone_number": "502-897-6500",
            "fax_number": "502-897-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "HARRY",
        "middle_name": "CALVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "16047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64160476",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.