NPIMap

Individual provider Active NPI

Stacey E Bishop Yeatman, M.D.

  • Family Medicine Physician
  • Highland Heights, KY
National Provider Identifier
1770520975
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39539 Issued in KY
Practice address
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone
(859) 781-4111
Fax
(859) 441-5214
NPI assigned
May 31, 2006
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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 39539 KY Primary

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 names 1

  • Stacey Bishop Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050721000075 KY Practitioner - Family Practice 8022045095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 2163326240, 803 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jan 1, 2010 Accepting new patients
Summit Medical Group, Inc Family Medicine CurrentSince Jan 1, 2010 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

340 Thomas More Pkwy
#160
Crestview Hills, KY 41017

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

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

  • Direct secure messaging: sbishopyeatman5593@direct-prd.stelizabeth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Elizabeth PhysiciansRising Sun, IN, CCN 153958 Rural health clinic Corporate Director Jan 1, 2018
St. Elizabeth PhysiciansMilan, IN, CCN 153956 Rural health clinic Corporate Director Jan 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1770520975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-781-4111",
            "fax_number": "859-441-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 ALEXANDRIA PIKE",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410761530",
            "telephone_number": "859-781-4111",
            "fax_number": "859-441-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP YEATMAN",
        "first_name": "STACEY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "39539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BISHOP",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland Heights, KY

Sources for this page

Verify at the official NPI Registry.