Individual provider Active NPI

Scott Gregory Stephen, PA-C

  • Surgical Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1881979003
Registry record updated Aug 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3320 Issued in CO
Practice address
627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone
(970) 242-3535
Fax
(970) 623-8599
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 3320 CO Primary

Addresses

Primary practice location

627 25 1/2 Rd
Grand Junction, CO 81505-6401

Mailing address

627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone (970) 242-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120224000446 CO Practitioner - Physician Assistant 7214195080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Valley OrthopedicsGroup PAC ID 8820353964, 27 clinicians

Practice addresses (Care Compare)

2373 G Rd
Grand Junction, CO 81505-1003

Hospital & facility affiliations

  • Community Hospital Hospital, Grand Junction, CO, CCN 060054
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302
  • Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3320COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC CurrentSince Feb 11, 2021 Accepting new patients
Grand Valley Orthopedics CurrentSince Sep 1, 2018 Accepting new patients
Community Medical Group, LLC CurrentSince Feb 11, 2021 Accepting new patients
Community Medical Group, LLC Past Accepting new patients
Grand Valley Orthopedics Past Accepting new patients

Locations

2373 G Rd
Ste 280
Grand Junction, CO 81505
Phone (970) 243-9343

2373 G Rd
Ste 100
Grand Junction, CO 81505
Phone (970) 245-0484

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1881979003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-623-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-623-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "SCOTT",
        "middle_name": "GREGORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "3320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.