Debra Lynn Stephens, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71000422A Issued in IN

Practice address

3011 W Smokey Row Rd
Ste. a
Bargersville, IN 46106-8803

Phone

(317) 535-0453

Fax

(318) 535-0467

NPI assigned

Jul 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Old Schoolhouse Pediatrics Inc

  • Pediatrics Physician
  • Bargersville, IN
  • NPI 1720180862
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1821095977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 W SMOKEY ROW RD",
            "address_2": "STE. A",
            "city": "BARGERSVILLE",
            "state": "IN",
            "postal_code": "461068803",
            "telephone_number": "317-535-0453",
            "fax_number": "318-535-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W SMOKEY ROW RD",
            "address_2": "STE. A",
            "city": "BARGERSVILLE",
            "state": "IN",
            "postal_code": "461068803",
            "telephone_number": "317-535-0453",
            "fax_number": "318-535-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28062242A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000422A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200405900",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200168550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles A Salazar, MD
• Navneet Kaur Saran, FNP
• Ronnecia Smith
• Tiffani Chanel Speller, MSA
• Autumn Stepanek
• Sun Medical
• Rex Alan Thorne
• Moxi Trivedi
• Mercedez Urban, RBT
• Jan Vander Luitgaren, RN

• Nurse Practitioner in Bargersville, IN
• Providers in Bargersville, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.