Kimberlly Joy Stevens, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201703307NP-PP Issued in OR

Practice address

145 NE Broadway St
Myrtle Creek, OR 97457-9039

Phone

(541) 677-7200

Fax

(541) 229-3309

NPI assigned

May 12, 2017

Last updated

Apr 26, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cow Creek Band of Umpqua Tribe of IndiansGroup PAC ID 8921099474, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberlly.stevens@cchwc.directbygreenway.com

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.

• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Ctr

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1063502714

  TX

  Medicare reassignment Care Compare group NPD
• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1134436637
  Medicare reassignment NPD
• Centennial Medical Group East, LLC

  dba Evergreen Family Medicine North

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111
  NPD
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Roseburg, OR
  • NPI 1235688805
  NPD
• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
  • NPI 1134567993
  NPD
• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Glide, OR
  • NPI 1609065010
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1851828511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2589 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716224",
            "telephone_number": "541-839-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 NE BROADWAY ST",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974579039",
            "telephone_number": "541-677-7200",
            "fax_number": "541-229-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KIMBERLLY",
        "middle_name": "JOY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201703307NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500725333",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralph Michael Shirtcliff, D.M.D.
• Kristina A Skinner, FNP
• Jackie J Sochin, FNP - CERTIFIED
• South Umpqua Integrated Health LLC
• Christopher L Stern, LMT
• Therapeutic Associates Inc (TAI - Myrtle Creek Physical Therapy)
• Trang Tran
• Tricity Chiropractic
• Umpqua Community Health Center, Inc. (Myrtle Creek Dental Clinic)
• Umpqua Community Health Center, Inc.

• Family Nurse Practitioner in Myrtle Creek, OR
• Providers in Myrtle Creek, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.