Ian Knowlton Pattison Stephens, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

929 Issued in NE

Practice address

13460 Walsh Dr
Boys Town, NE 68010-7529

Phone

(402) 498-3358

Fax

(402) 498-3375

NPI assigned

Jul 23, 2014

Last updated

Jul 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Father Flanagan's Boys' Home

  dba Boys Town Professional Services

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825
  Medicare reassignment NPD

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1962810804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "402-498-3358",
            "fax_number": "402-498-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "402-498-3358",
            "fax_number": "402-498-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "IAN",
        "middle_name": "KNOWLTON PATTISON",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "4770",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "530",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Slizinski
• Quinn Smith, MD
• Kara Maureen Snider, PLMHP
• Douglas F Spellman, M.D.
• Katherine L Stade
• Christian Stewart, LP
• Christina Marie Stoller, LMHP, LIMHP
• Heather Nicole Styles-Turbyfill, PSYD
• Ashley Laura Sudyka, APRN
• Melissa Suh, M.D.

• Psychologist in Boys Town, NE
• Providers in Boys Town, NE by specialty
• Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.