Active NPI
Stephanie Sue Starkovich, C.C.P.
- Perfusionist
- Lubbock, TX
National Provider Identifier
1770704033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- PF0201
- Practice address
- Covenant Medical Center
3615 19TH Street
Lubbock, TX 79410 - Phone
- (806) 725-4275
- NPI assigned
- May 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | PF0201 | TX | Primary |
Addresses
Primary practice location
Covenant Medical Center
3615 19TH Street
Lubbock, TX 79410
Mailing address
5508 68TH Street
Lubbock, TX 79424
Phone (806) 794-6715
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PF0201 | TX | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770704033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5508 68TH STREET",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79424",
"telephone_number": "806-794-6715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COVENANT MEDICAL CENTER",
"address_2": "3615 19TH STREET",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79410",
"telephone_number": "806-725-4275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARKOVICH",
"first_name": "STEPHANIE",
"middle_name": "SUE",
"credential": "C.C.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "TX",
"license": "PF0201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.