SHANE STEPHENS (NPI# 1285117606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285117606 |
| Entity Type | Individual |
| Full Name | SHANE STEPHENS |
| Practice Address |
1025 Executive Park Blvd Kingsport TN 37660-4620 |
| Mailing Address |
7032 Robinette Valley Rd Duffield VA 24244-2979 |
| Practice Telephone | 8333707433 |
| Mailing Telephone | 8285515679 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
24695 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1025 EXECUTIVE PARK BLVD |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1205443058 | Clinton Davis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-09-25 |
| 1063021087 | Leslie Renee Trivett | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-07-27 |
| 1114543642 | Phillip Connors | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-06-20 |
| 1477103661 | Mary Evans | Social Worker | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-09-19 |
| 1063065621 | Stefani Ellis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-07-22 |
| 1245798107 | Kelly Hyder | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| 1316323231 | Alexandra Rebecca Mccracken | Speech-Language Pathologist | 301 Louis St. #101, Mountain Region Speech & Hearing Center, Kingsport, TN 37660 | 2015-08-03 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972966 | Rebecca Singleton | Nurse Practitioner | 2601 N John B Dennis Hwy Apt 2318, Kingsport, TN 37660-0835 | 2020-11-03 |
| 1205443058 | Clinton Davis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-09-25 |
| 1063021087 | Leslie Renee Trivett | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-07-27 |
| 1114543642 | Phillip Connors | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-06-20 |
| 1063065621 | Stefani Ellis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-07-22 |
| 1558569426 | Joan Colette D'cruz | Nurse Practitioner | 1944 Brookside Dr, Suite 1, Kingsport, TN 37660-4618 | 2007-07-03 |
| 1730230681 | Maureen A Gaynor | Nurse Practitioner | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2007-01-16 |
| 1851304604 | Ashley Taylor | Nurse Practitioner | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434503 | Sonya Lavet Butler | Nurse Practitioner | 3413 Axelwood Dr, Murfreesboro, TN 37128-3984 | 2020-10-09 |
| 1417554361 | John Pearson Redmond | Nurse Practitioner | 1710 Ghost Creek Dr, Collierville, TN 38017-3425 | 2020-10-05 |
| 1861099061 | Justin Mccord | Nurse Practitioner | 454 Red Hill Center Rd, Lawrenceburg, TN 38464-6842 | 2020-10-01 |
| 1265049977 | Toya Owens | Nurse Practitioner | 2565 Mackinnon Dr, Memphis, TN 38119-7903 | 2020-09-26 |
| 1043827041 | Zamaria Davion Louise Gains | Nurse Practitioner | 7405 Shallowford Rd Ste 230, Chattanooga, TN 37421-7632 | 2020-09-24 |
| 1376158998 | Mary L Dean Turner | Nurse Practitioner | 6727 Stonetrace Dr, Bartlett, TN 38135-3054 | 2020-09-10 |
| 1205447794 | Sana Pathan | Nurse Practitioner | 829 S Sherbrooke Cir, Mount Carmel, TN 37645-4019 | 2020-08-10 |
| 1093325557 | Highland Behavioral Healthcare | Nurse Practitioner | 29 Taylor Ave Ste 204, Crossville, TN 38555-4537 | 2020-08-08 |
| 1225648009 | Angela R Davenport | Nurse Practitioner | 7110 Crossroads Blvd, Brentwood, TN 37027-2826 | 2020-08-05 |
| 1952919102 | Renee Mathis | Nurse Practitioner | 2308 Collierville Arlington N, Eads, TN 38028-9302 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.