Sean Rayl Stephenson, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101016669 Issued in MI

Practice address

305 N Leroy St
Fenton, MI 48430-2729

Phone

(810) 629-0336

Fax

(810) 629-7251

NPI assigned

Aug 5, 2006

Last updated

Apr 30, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatopathology Laboratory of Central States

  • Clinical Medical Laboratory
  • Dayton, OH
  • NPI 1912914144

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1942219621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302729",
            "telephone_number": "810-629-0336",
            "fax_number": "810-629-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302729",
            "telephone_number": "810-629-0336",
            "fax_number": "810-629-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "SEAN",
        "middle_name": "RAYL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101016669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114917041",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114917097",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114917050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Starr
• Joseph Paul Starrs, R.PH.
• Margorie Stclair
• Kenneth R Steibel, M.D.
• Daniel A Steinhardt, PHD
• Tayler Rain Stevens, LLPC
• Clarissa Dawn Stewart -Guest, ACUPUNCTURE
• Rebecca Anne Stiff, LPTA
• Brian E Stone, DC
• Richard Preston Stork, D.C.

• General Practice Physician in Fenton, MI
• Providers in Fenton, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.