Mary Deann Stephens, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

104480 Issued in MO

Practice address

102 Hospitality Dr
Sikeston, MO 63801-9382

Phone

(573) 471-0200

Fax

(573) 471-7559

NPI assigned

Nov 6, 2006

Last updated

Feb 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860
  Medicare reassignment NPD
• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1962571083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HOSPITALITY DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019382",
            "telephone_number": "573-471-0200",
            "fax_number": "573-471-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOSPITALITY DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019382",
            "telephone_number": "573-471-0200",
            "fax_number": "573-471-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MARY",
        "middle_name": "DEANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "104480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of Missouri (Southeast Missouri Residential Services-Sikeston Prof Grp)
• State of Missouri (Southeast Missouri Residential Services-Sikeston)
• Lindsey Rachell Steele, COTA
• Jennifer Marie Steelman, M.A.,CCC-SLP
• James Dylan Stephens, PA-C
• Morgan Renee Stephens
• Laura Sternberg, LPC
• Steven C Barnett OD LLC
• Melissa A Stewart
• Jennifer Lee Sticht, OTR

• Pediatric Nurse Practitioner in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.