Stephen Dale Bovenkerk, D.O.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

82870 Issued in GA

Practice address

2151 W Spring St Ste B120
Monroe, GA 30655-3210

Phone

(770) 207-0215

NPI assigned

Apr 3, 2007

Last updated

Sep 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, GA2 enrollments

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 2

Specialty

Otolaryngology

Education

Midwestern University, Chicago College of Osteopathic Med, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alpharettasurgerycenter.stephenbovenkerk@120997.advancedmd-direct.com

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Milton Hall Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Alpharetta, GA
  • NPI 1619004306
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation
• Piedmont Newton Hospital, Inc.

  dba Newton Medical Center

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation
• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328
  Care Compare affiliation

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1760503171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S CLEVELAND AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853002",
            "telephone_number": "269-982-3368",
            "fax_number": "269-983-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W SPRING ST STE B120",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553210",
            "telephone_number": "770-207-0215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2680 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490853002",
            "country_code": "US",
            "telephone_number": "269-982-3368",
            "fax_number": "269-983-3238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOVENKERK",
        "first_name": "STEPHEN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "82870",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101015878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Board of Health Walton County (Walton County Health Department)
• Keith Boddie, PT
• Marlynn Newsome Bohannon, LCSW
• David Bruce Bollinger, OTR/L
• Lauren Bonnett, PHARMD
• Sharon Malone Bowden, COTA
• Christina Bradford, FNP-C
• Kate Ann Breiner, NP
• Catilin Briscoe, NP
• Steven Broadway, PTA

• Otolaryngology Physician in Monroe, GA
• Providers in Monroe, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.

Verify at the official NPI Registry.