SAMANTHA JO STEPHENS AGACNP-BC NPI 1871291930

NPI Information

  • NPI: 1871291930
  • Provider Name: SAMANTHA JO STEPHENS, AGACNP-BC
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 701 E COUNTY LINE RD STE 101
    GREENWOOD, IN
    ZIP 46143
  • Phone: (317) 363-1316

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NPI Details

Samantha Jo Stephens, AGACNP-BC is a gerontology nurse practitioner in Greenwood, IN with 2 years of experience. Samantha Jo Stephens, AGACNP-BC NPI is 1871291930. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 E COUNTY LINE RD STE 101
GREENWOOD, IN
ZIP 46143-070
Phone: (317) 363-1316

The NPI 1871291930 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/20/2023 and was last updated on 12/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner71014072AINDIANANo
2363LA2200XNurse PractitionerAdult Health71014072AINDIANANo
3363LG0600XNurse PractitionerGerontology71014072AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300080585MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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