Individual provider Active NPI

Michael Sean Stephens, ANP

  • Adult Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1861435869
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5004332 Issued in NC
Practice address
11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375
Phone
(919) 562-9410
Fax
(919) 562-2948
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5004332 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375

Mailing address

PO Box 1107
Wake Forest, NC 27588-1107
Phone (919) 562-9410

Other practice location 1

103 Professional Park Ste A
Oxford, NC 27565-2581
Phone (919) 562-9410

Other practice location 2

200 W Parkview Dr Ste B
Henderson, NC 27536-5958
Phone (919) 562-9410

Other practice location 3

6602 Knightdale Blvd Ste 310
Knightdale, NC 27545-6526
Phone (919) 562-9410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090416000743 NC Practitioner - Nurse Practitioner 0840293601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

11221 Galleria Ave
Suite 101
Raleigh, NC 27614-8137
Phone (919) 562-9410

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2642NCMDPhysical Therapist
5004332NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Oct 13, 2014 Accepting new patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Oct 13, 2014 Accepting new patients
Atlantic Radiology Associates PA Past Accepting new patients

Locations

200 W Parkview Dr
#B
Henderson, NC 27536

6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545

103 Professional Park
Ste A
Oxford, NC 27565
Phone (919) 693-7108

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

11221 Galleria Ave
#101
Raleigh, NC 27614
Phone 9195629410213

5838 Six Forks Rd
Ste 100
Raleigh, NC 27609

1936 Golden Spur Ln
Wendell, NC 27591

Interoperability endpoints

  • Direct secure messaging: michael.stephens.1@12529.direct.athenahealth.com

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1861435869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881107",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY STE 309",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147375",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Professional Park Ste A",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "NC",
            "postal_code": "275652581",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Parkview Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275365958",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6602 Knightdale Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MICHAEL",
        "middle_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.