MR. CHRISTODULOS STEFANATOS STAVENS (NPI# 1659457232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659457232 |
| Entity Type | Individual |
| Full Name | MR. CHRISTODULOS STEFANATOS STAVENS |
| Credential | M.D. |
| Practice Address |
100 Mallard Creek Rd Suite 150 Louisville KY 40207-4194 |
| Practice Telephone | 5025897907 |
| Practice Fax Number | 5025891319 |
| Mailing Telephone | 5025897907 |
| Mailing Fax Number | 5025891319 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2015-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01035475A | IN | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
24509 | KY | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
24509 | KY | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
24509 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE | 060052924 | 01 |
| KY | SIHO HEALTH PLAN | 415633P | 01 |
| PASSPORT HEALTH PLAN | 1052057 | 01 | |
| FIRST HEALTH | 687915 | 01 | |
| KY | RAILROAL MEDICARE/TVILLE | 060052921 | 01 |
| KY | 64245095 | 05 | |
| KY | ANTHEM BCBS | 000000052133 | 01 |
| IN | RAILROAD MEDICARE/MADISON | 060053877 | 01 |
| IN | 200040930 | 05 | |
| KY | UNITED HEALTHCARE | 25-00167 | 01 |
| FEDERAL BLACK LUNG PROGRA | 299856 | 01 |
| Street Address |
100 MALLARD CREEK RD SUITE 150 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285622779 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 100 Mallard Creek Rd, Suite 150, Louisville, KY 40207-4194 | 2005-10-10 |
| 1497130017 | Phyllis Eugenia Moore | Nurse Practitioner | 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-4194 | 2015-07-24 |
| 1104213388 | Chad C Lanphear | Anesthesiologist Assistant | 100 Mallard Creek Rd, Louisville, KY 40207-4194 | 2015-04-24 |
| 1598163958 | Paige Faye Eggers | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2014-12-16 |
| 1407271562 | Brittney Leigh Porter | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2014-02-26 |
| 1548691876 | Heath Webb Perkins | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2013-12-12 |
| 1184066474 | Alison Elizabeth Hewett | Nurse Practitioner | 100 Mallard Creek Rd, Ste. 320, Louisville, KY 40207-4194 | 2013-07-27 |
| 1457795734 | David J Roach | Emergency Medicine | 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-5166 | 2013-04-17 |
| 1831434505 | Lori Sexton | Specialist/Technologist, Other | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2012-12-06 |
| 1790020469 | Hanna Vaughn | Specialist/Technologist, Other | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2012-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881182657 | Have A Heart Foundation Inc | Internal Medicine | 310 E Broadway Ste 100, Louisville, KY 40202-1745 | 2018-04-27 |
| 1104356567 | Mmr Cardiovascular Consulting LLC | Internal Medicine | 1101 Glenlake Way, Louisville, KY 40245 | 2017-06-18 |
| 1992246953 | Northeast Cardiology Pllc | Internal Medicine | 1313 St.anthony Place, Louisville, KY 40204-0130 | 2017-03-10 |
| 1427410596 | Lauren Albers | Internal Medicine | 550 South Jackson St, Louisville, KY 40202 | 2016-03-28 |
| 1396138202 | Louisville Cardiovascular Care Pllc | Internal Medicine | 1411 Hadleigh Pl, Louisville, KY 40222-5652 | 2015-03-17 |
| 1629481270 | Harleen Chahil | Internal Medicine | 201 Abraham Flexner Way Ste 600, Louisville, KY 40202-3841 | 2014-06-10 |
| 1831415579 | Geko Inc | Internal Medicine | 1552 Ormsby Station Ct, Louisville, KY 40223-4019 | 2010-04-19 |
| 1215179908 | Matthew Cody Lee Keith | Internal Medicine | 9070 Dixie Hwy Ste 6, Louisville, KY 40258-1007 | 2009-03-27 |
| 1578691622 | John Loughran Jr. | Internal Medicine | 3900 Kresge Way Ste 60, Louisville, KY 40207-4690 | 2007-03-01 |
| 1316024722 | Cardiology of Kentucky | Internal Medicine | 4003 Kresge Way Ste 221, Louisville, KY 40207-4652 | 2006-11-01 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
Please comment or provide details below to improve the information on MR. CHRISTODULOS STEFANATOS STAVENS.
| 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.