Stacey E Bishop Yeatman, M.D.
Individual provider Active NPI Family Medicine Physician · Highland Heights, KY
NPI 1770520975 · NPPES record last updated Apr 13, 2020
Key facts
- NPI
- 1770520975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 39539 (KY)
- Practice address
- 2626 Alexandria Pike
Highland Heights, KY 41076-1530 - Phone
- (859) 781-4111
- Fax
- (859) 441-5214
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 8
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Summit Medical Group Inc
Practice addresses (Care Compare)
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 301-5901
300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400
85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 301-5901
PO Box
Suite 635283
Cincinnati, OH 45263-5283
Hospital & facility affiliations
- St Elizabeth Home Care
- Centerwell Home Health
- Caretenders of Northern Kentucky
- St Elizabeth Edgewood
- St Elizabeth Ft Thomas
- St Elizabeth Florence
- St Elizabeth Grant
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| St. Elizabeth Physicians |
Rural health clinic | Corporate Director | Jan 1, 2018 |
| St. Elizabeth Physicians |
Rural health clinic | Corporate Director | Jan 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050721000075 | KY | Practitioner - Family Practice | 8022045095 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Family Medicine | Current |
Accepting new patients |
| Summit Medical Group, Inc. | Current |
Accepting new patients | |
| Cincinnati Health Care Group PSC | Past | Accepting new patients |
Locations
125 Saint Michael Dr
Cold Spring, KY 41076
Phone (859) 441-3120
351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000
340 Thomas More Pkwy
#160
Crestview Hills, KY 41017
7766 Ewing Blvd
Florence, KY 41042
Phone (859) 283-1033
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- sbishopyeatman5593@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39539 | KY | Yes |
Addresses
Primary practice location
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 781-4111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00839854 | Other | KY | RAILROAD MEDICARE |
| P00243169 | Other | KY | RAILROAD MEDICARE |
| 2599997 | Medicaid | OH | |
| 64109945 | Medicaid | KY |
Other names
- Stacey Bishop
Other providers in Highland Heights, KY
- Summer Beavers
- Michael Douglas Bennett
- Bryan Joel Berman
- Alexander Bessler
- James Thomas Bilbo
- Brian D Blevins
- Victoria Renee Bobinski
- Sandy Bollhauer
- Bowling Chiropractic, PSC
- Sheila Lynn Bowling-Herald
All providers in Highland Heights, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.