Mattea D Stephens

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

167459.MEDS-IV Issued in OH

Practice address

2875 Tara TRL
Beavercreek, OH 45434-6250

Phone

(937) 901-0434

NPI assigned

Apr 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1740925296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 TARA TRL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346250",
            "telephone_number": "937-901-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 TARA TRL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346250",
            "telephone_number": "937-901-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MATTEA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "167459.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Stark, OT
• Sarah Stauffer
• Justine Lauren Steele, MSW, LSW
• Lindsey Stefan
• Mary Steider, RBT
• Carrie Steward, APRN-CNP
• David K Stewart, O.D.
• Ilana Stewart
• Modena J Stewart
• Mark R Stobie, PCC, NCC

• Licensed Practical Nurse in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.