Individual provider Active NPI

Jeannie B Stephenson, PT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1851314595
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20601 Issued in FL
Practice address
13330 Usf Laurel Dr
MDC 90
Tampa, FL 33612-6601
Phone
(813) 974-8613
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20601 FL Primary

Addresses

Primary practice location

13330 Usf Laurel Dr
MDC 90
Tampa, FL 33612-6601

Mailing address

PO Box 917770
Orlando, FL 32891-7770

Other identifiers 2

IdentifierTypeStateIssuer
888139100MedicaidFL
Y011AOtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040302000813 FL Practitioner - Physical Therapist in Private Practice 7911894167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Virginia Commonwealth University, School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

13330 Usf Laurel Dr
3Rd Floor
Tampa, FL 33612-6601
Phone (813) 821-8038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20601FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Dec 15, 2017 Accepting new patients
University Medical Service Association Inc Physical Therapist CurrentSince Dec 15, 2017 Accepting new patients

Locations

13330 Usf Laurel Dr
#90
Tampa, FL 33612
Phone (813) 974-8613

13330 Usf Laurel Dr
Fl 3
Tampa, FL 33612
Phone (813) 396-9422

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jstephenson136004@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1851314595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 USF LAUREL DR",
            "address_2": "MDC 90",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126601",
            "telephone_number": "813-974-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JEANNIE",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888139100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y011A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.