Benjamin Robert Stevens, FNP-C

Key facts

NPI

1871007146

Entity type

Individual (NPI type 1)

Primary specialty

Primary Care Nurse Practitioner 363LP2300X

License

4704301140 (MI)

Practice address

4150 E Beltline Ave NE Ste 3
Grand Rapids, MI 49525-9316

Phone

(616) 447-9888

NPI assigned

Nov 25, 2017

Sex

Male

Sole proprietor

No

Organizations & group practices 6

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.

• Peak Performance Integrated Medicine, PLC Chiropractor · Grand Rapids, MI · NPI 1932250693
  Medicare reassignment Care Compare group MI
• Las Colinas Physical Medicine PLLC Internal Medicine Physician · Irving, TX · NPI 1578285755
  NPD FAMILY
• Apex Medical Group, PLLC General Practice Physician · Prosper, TX · NPI 1366908360
  NPD (past)
• Austin Oaks Physical Medicine PLLC Internal Medicine Physician · Austin, TX · NPI 1003538182
  NPD (past) FAMILY
• Sundance Physical Medicine PLLC Internal Medicine Physician · Fort Worth, TX · NPI 1831811918
  NPD (past) FAMILY
• V. John Gonino D.O, P.a. Family Medicine Physician · Heath, TX · NPI 1346493285
  NPD (past)

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Integrated Medicine PLC (5 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 30, 2024.

{
    "created_epoch": "1511568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1871007146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 FARM CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467932",
            "telephone_number": "616-644-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 E BELTLINE AVE NE STE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259316",
            "telephone_number": "616-447-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7718 Wood Hollow Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787311602",
            "country_code": "US",
            "telephone_number": "737-304-7500",
            "fax_number": "737-403-7501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 W 7th St Ste 450",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761022601",
            "country_code": "US",
            "telephone_number": "817-935-8200",
            "fax_number": "817-887-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "122 W John Carpenter Fwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750392024",
            "country_code": "US",
            "telephone_number": "972-378-0383",
            "fax_number": "972-403-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-25",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1035992",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704301140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

• Steven G. Hamming, Psy.D., PC
• Aimee Blanke Stevens, LMSW
• Alison Stevens
• Amanda Joy Stevens, DO
• Andrew Stevens, MD
• Domonique Stevens, LMSW
• Duncan Stevens, MD
• Erica Elsing Stevens, D.O.
• Geoffery Lyle Stevens, LMSW,CSW
• Grant Stevens, DPT

All providers in Grand Rapids, MI · Primary Care Nurse Practitioner in Michigan