Individual provider Active NPI

John V Stephens, MD

  • Rehabilitation Practitioner
  • Kalispell, MT
National Provider Identifier
1861597684
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
3823 Issued in MT
Practice address
1250 Burns Way
Suite 4
Kalispell, MT 59901
Phone
(406) 752-2155
Fax
(406) 752-0252
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 3823 MT Primary

Addresses

Primary practice location

1250 Burns Way
Suite 4
Kalispell, MT 59901

Mailing address

1250 Burns Way
Suite 4
Kalispell, MT 59901
Phone (406) 752-2155

Other identifiers 1

IdentifierTypeStateIssuer
62127MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000292 MT Practitioner - Physical Medicine and Rehabilitation 5890727457 Practice locations: Kalispell, MT

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Washington School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1250 Burns Way
Suite 4
Kalispell, MT 59901-3110
Phone (406) 752-2155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3823MTMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861597684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BURNS WAY",
            "address_2": "SUITE 4",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "59901",
            "telephone_number": "406-752-2155",
            "fax_number": "406-752-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BURNS WAY",
            "address_2": "SUITE 4",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "59901",
            "telephone_number": "406-752-2155",
            "fax_number": "406-752-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JOHN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "MT",
            "license": "3823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62127",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.