Active NPI
Lisa Dawn Stephens, MD
- Pediatrics Physician
- Virginia Beach, VA
National Provider Identifier
1962445429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101226853
- Practice address
- 1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019 - Phone
- (757) 507-0255
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101226853 | VA | Primary |
Addresses
Primary practice location
1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019
Mailing address
1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019
Phone (757) 507-0255
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006702171 | Medicaid | VI | |
| 22927925 | Other | VIRGINIA HEALTH NETWORK | |
| 541778786001 | Other | TRICARE | |
| 89063N4 | Medicaid | NC | |
| 29851 | Other | OPTIMA | |
| 452258 | Other | ANTHEM | |
| 006702171 | Other | VA PREMIER | |
| 229529252 | Other | UNITED HEALTH CARE | |
| 282142 | Other | MDIPA/MAMSI |
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 Medicine
Interoperability endpoints
- lstephens19932@direct.sentara.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1962445429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 GLENN MITCHELL DR STE 310",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234560019",
"telephone_number": "757-507-0255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 GLENN MITCHELL DR STE 310",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234560019",
"telephone_number": "757-507-0255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "LISA",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101226853",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006702171",
"state": "VI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA HEALTH NETWORK",
"identifier": "22927925",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "541778786001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89063N4",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA",
"identifier": "29851",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "452258",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA PREMIER",
"identifier": "006702171",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "229529252",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA/MAMSI",
"identifier": "282142",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.