Kirk Ronald Stephens, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

10476224-1206 Issued in UT

Practice address

7396 S Union Park Ave Ste 201
Midvale, UT 84047-6702

Phone

(801) 567-1400

NPI assigned

Aug 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physician Assistant

Education

University of Utah School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogden Clinic Specialty Services LLCGroup PAC ID 1658781422, 131 clinicians

Dermatology Center of Salt Lake Inc.Group PAC ID 7810903259, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Dermatology Center of Salt Lake Inc.

  • Specialist
  • Midvale, UT
  • NPI 1689635799
  Medicare reassignment Care Compare group
• Ogden Clinic Specialty Services LLC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668
  Medicare reassignment Care Compare group
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083

  Dermatology

  NPD

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1992221980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E 5900 S STE B111",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077293",
            "telephone_number": "801-268-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7396 S UNION PARK AVE STE 201",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840476702",
            "telephone_number": "801-567-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KIRK",
        "middle_name": "RONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "10476224-1206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "10476224-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Steenblik, LCSW
• Daina R Steffensen, CASE MANAGER
• Stellar Hospice Salt Lake LLC
• Stellar PCP LLC
• Angela M Stephany
• Hailee Stewart
• Debra Lynn Stone, ACNP-BC
• Rosalie Stone, OT
• Stonehaven Dental - Midvale, LLC
• Emily Stowe

• Dermatology Physician in Midvale, UT
• Providers in Midvale, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.