Individual provider Active NPI

Linda A Iskra-Stevenson, M.D.

  • Pediatrics Physician
  • South Bloomfield, OH
National Provider Identifier
1902906183
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35-07-1367 I Issued in OH
Practice address
5030 N Walnut St
South Bloomfield, OH 43103-1018
Phone
(740) 983-0015
Fax
(740) 983-4763
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35-07-1367 I OH Primary

Addresses

Primary practice location

5030 N Walnut St
South Bloomfield, OH 43103-1018

Mailing address

5030 N Walnut St
South Bloomfield, OH 43103-1018
Phone (740) 983-0015

Other identifiers 1

IdentifierTypeStateIssuer
2061236MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200408004335 OH Practitioner - Pediatric Medicine 8628972965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Ohio State University College of Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5030 N Walnut St
South Bloomfield, OH 43103-1018
Phone (740) 983-0015

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Community Practices, LLC Pediatrics CurrentSince May 18, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1264 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-6801

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

5030 N Walnut St
South Bloomfield, OH 43103
Phone (740) 983-0015

Organizations & group practices 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1902906183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 N WALNUT ST",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431031018",
            "telephone_number": "740-983-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 N WALNUT ST",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431031018",
            "telephone_number": "740-983-0015",
            "fax_number": "740-983-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKRA-STEVENSON",
        "first_name": "LINDA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-07-1367 I",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2061236",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bloomfield, OH

Sources for this page

Verify at the official NPI Registry.