Active NPI
Kenneth E Stephens, D.O.
- Orthopaedic Hand Surgery Physician
- East Lansing, MI
National Provider Identifier
1891760971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 5101010508
- Practice address
- 830 W Lake Lansing Rd
Suite 190
East Lansing, MI 48823-6371 - Phone
- (517) 333-3777
- Fax
- (517) 203-3956
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 5101010508 | MI | Primary |
Addresses
Primary practice location
830 W Lake Lansing Rd
Suite 190
East Lansing, MI 48823-6371
Mailing address
830 W Lake Lansing Rd
Suite 190
East Lansing, MI 48823-6371
Phone (517) 333-3777
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300040412 | Other | MI | TRICARE |
| 1017937 | Other | MI | MCLAREN HEALTH ADVANTAGE |
| 200C313650 | Other | MI | BLUECARE NETWORK |
| 4838574 | Medicaid | MI | |
| 200000001155 | Other | MI | PHYSICIANS HEALTH PLAN |
| 0970031 | Other | MI | PHP-FAMILY CARE |
| 200C313650 | Other | MI | BCBS MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101010508 | MI | MD | Orthopaedic Hand Surgery Physician |
| 10508 | MI | MD | Non-emergency Medical Transport (VAN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412812800000",
"number": "1891760971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 W LAKE LANSING RD",
"address_2": "SUITE 190",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488236371",
"telephone_number": "517-333-3777",
"fax_number": "517-203-3956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 W LAKE LANSING RD",
"address_2": "SUITE 190",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488236371",
"telephone_number": "517-333-3777",
"fax_number": "517-203-3956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "KENNETH",
"middle_name": "E",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2014-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "MI",
"license": "5101010508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "300040412",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH ADVANTAGE",
"identifier": "1017937",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE NETWORK",
"identifier": "200C313650",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4838574",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS HEALTH PLAN",
"identifier": "200000001155",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP-FAMILY CARE",
"identifier": "0970031",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MI",
"identifier": "200C313650",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.