NPIMap

Individual provider Active NPI

Stephen L Kinser, MD

  • Family Medicine Physician
  • Clyde, NC
National Provider Identifier
1740634526
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-01190 Issued in NC
Practice address
6750 Carolina Blvd
Clyde, NC 28721-7052
Phone
(828) 627-2211
NPI assigned
Apr 19, 2016
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2019-01190 NC Primary

Addresses

Primary practice location

6750 Carolina Blvd
Clyde, NC 28721-7052

Mailing address

6750 Carolina Blvd
Clyde, NC 28721-7052
Phone (423) 557-8519

Other practice location 1

1100 East Third Street
Chattanooga, TN 37403
Phone (423) 778-2957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112001850 NC Practitioner - Family Practice 6608165303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midway Medical Center PAGroup PAC ID 0547208860, 8 clinicians

Practice addresses (Care Compare)

6750 Carolina Blvd
Clyde, NC 28721-7052
Phone (828) 627-2211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-01190NCMDFamily Medicine Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1740634526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 CAROLINA BLVD",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217052",
            "telephone_number": "423-557-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 CAROLINA BLVD",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217052",
            "telephone_number": "828-627-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 East Third Street",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "37403",
            "country_code": "US",
            "telephone_number": "423-778-2957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSER",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.