Individual provider Active NPI

Cameron Stephenson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rexburg, ID
National Provider Identifier
1790065738
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
75884 Issued in ID
Practice address
393 E 2ND N
Rexburg, ID 83440-1605
Phone
(208) 359-6498
Fax
(208) 488-4702
NPI assigned
Aug 22, 2011
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3009120 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 75884 ID Primary

Addresses

Primary practice location

393 E 2ND N
Rexburg, ID 83440-1605

Mailing address

393 E 2ND N
Rexburg, ID 83440-1605
Phone (208) 359-6498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725001511 ID Practitioner - Nurse Practitioner 4385929819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Co Memorial HospitalGroup PAC ID 8123016367, 34 clinicians

Practice addresses (Care Compare)

37 S 2ND
Rexburg, ID 83440-1906
Phone (208) 356-0234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
75884IDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Co Memorial Hospital Family Medicine Current Accepting new patients
Madison Co Memorial Hospital Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Rocky Mountain Child and Adolescent Psychiatry Psychiatric/Mental Health CurrentSince Mar 11, 2025 Accepting new patients
Madison Co Memorial Hospital Family Medicine Past Accepting new patients
Madison Co Memorial Hospital Psychiatric/Mental Health Past Accepting new patients
Madison Co Memorial Hospital Past Accepting new patients

Locations

37 S 2nd E
Rexburg, ID 83440
Phone (208) 356-0234

37 S 2nd E
Ste 300
Rexburg, ID 83440

393 E 2nd N
Rexburg, ID 83440
Phone (208) 356-5401

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

Interoperability endpoints

  • Direct secure messaging: cameron.stephenson.1@19475.direct.athenahealth.com
  • Direct secure messaging: cameron.stephenson.2@33316.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1790065738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-6498",
            "fax_number": "208-488-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-6498",
            "fax_number": "208-488-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "CAMERON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3009120",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "75884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.