Physician Compare National (NPI:1336212752)

HEALTHCARE PROVIDER: KAY STEPHENS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336212752
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830261049
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080703000301
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STEPHENS
	Individual professional last name
Provider First Name	KAY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2440 SR MARY COLUMBA DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	RED BLUFF
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	960804356
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5305294727
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050042
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST ELIZABETH COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y