Stephen C Provenza
Physician Assistant

Address: 745 N Swope St, Greenfield, IN 46140
Phone: 3174629221

Stephen C Provenza (NPI# 1124113998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1124113998
Entity Type Individual
Full Name Stephen C Provenza
Credential PA
Gender Male
Practice Address 745 N Swope St
IN 46140
Practice Telephone 3174629221
Practice Fax Number 3174623400
Mailing Address 2741 W Layton Ave Ste 106
WI 53221-2600
Mailing Telephone 4142425468
Mailing Fax Number 8887240875
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-10-04
Last Update Date 2019-03-08

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers 10001076A IN

Other Provider Identifier

State Identifier Issuer Type Code

Secondary Practice Locations

Address Telephone Number Fax Number
2502 25th St, Columbus, IN 472013728 8123728883 8123728964

Physician Overview

NPI 1124113998
PAC ID by PECOS 5395056261
Professional Enrollment ID I20150618001377
Full Name Stephen Provenza
Phone Number 3178819792
Gender M
Graduation Year 2001
Group Practice PAC ID 9830371731
Number of Group Practice Members 4
Accepts Medicare Assignment Y

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356963961 Anna Turner Physician Assistant 1287 Capstone Dr, Greenfield, IN 46140-2676 2020-05-18
1891334926 Amber Davidson Physician Assistant 739 Lynn Point Rd, Greenfield, TN 38230-4003 2020-01-06
1356520720 Jyoti J. Zaveri Physician Assistant 300 E Boyd Ave Ste 100, Greenfield, IN 46140-2816 2007-11-01
1538172697 David Jeffrey Wilbert Physician Assistant 801 S Meridian St, Greenfield, TN 38230-2104 2006-08-13
1902878242 Annah C Houk Physician Assistant 6901 W Edgerton Ave, Greenfield, WI 53220-4420 2006-02-02
1235115213 Mark Steven Clark Physician Assistant 1 Verney Drive, Greenfield, NH 03047 2005-12-21
1265418826 Stephen Pasquini Physician Assistant 467 El Camino Real, Greenfield, CA 93927-4915 2005-12-15
1386206233 Lea Z Sack Physician Assistant 6901 W Edgerton Ave, Greenfield, WI 53220-4420 2019-07-01
1124689666 Jenna M Mineau Physician Assistant 9000 W Sura Ln, Greenfield, WI 53228-3477 2019-06-25
1386204428 David Finn Olcott Physician Assistant 329 Conway St, Greenfield, MA 01301-1521 2019-06-20
Find all providers in GREENFIELD

Office Location

Street Address 745 N SWOPE ST
State IN
Zip Code 46140

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063468676 Hendricks County Hospital Skilled Nursing Facility 745 N Swope St, Greenfield, IN 46140-1332 2006-05-25
1467051730 Informe Healthcare Specialists, LLC Counselor 745 N Swope St, Greenfield, IN 46140-1332 2020-10-19
1417583220 Progressive Care Solutions of In, LLC Clinic/Center 745 N Swope St, Greenfield, IN 46140-1332 2020-03-13
1730622291 Dycora Transitional Health - Greenfield LLC Skilled Nursing Facility 745 N Swope St, Greenfield, IN 46140-1332 2016-11-30
1700335437 Nancy Ellen Eaton Nurse Practitioner 745 N Swope St, Greenfield, IN 46140 2016-09-22
1346608049 Joven Medical Group LLC Family Medicine 745 N Swope St, Greenfield, IN 46140-1332 2016-02-09
1114182383 Tisha Stine Occupational Therapist 745 N Swope St, Greenfield, IN 46140-1332 2008-07-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417504655 Megan Snider Nurse Practitioner 1120 S Jacobi Rd, Greenfield, IN 46140 2019-08-22
1598319048 Paul Vernon Runyan Jr. Counselor 5486 W Us Highway 40, Greenfield, IN 46140 2019-08-01
1467928457 Candace Kay Roudebush Developmental Therapist 1342 Fairview Dr, Greenfield, IN 46140 2018-10-17
1730660481 Samruddhi Dawande Physical Therapist 200 Green Meadows Drive, Greenfield, IN 46140 2018-08-21
1255794178 Claire Lubbers Nurse Practitioner 300 E. Boyd Ave., Suite Ahn-family Medicine, Greenfield, IN 46140 2016-03-29
1376905752 Justin Donat Pharmacist 2181 N West Bay Dr Apt D, Greenfield, IN 46140 2016-03-24
1265716476 Kathleen Theresa Picard-nance Pharmacist 1195 N State Street, Greenfield, IN 46140 2011-10-06
1780991513 Melinda Sue Wolfe Midwife, Lay 1929 Declaration Dr, Greenfield, IN 46140 2010-08-31
1669694287 Lifetime Dental Care of Indiana, PC Dentist 168 East New Road, Greenfield, IN 46140 2007-05-03
1790903177 Christina Renee Mcqueeney Audiologist 1834 Fields Blvd, Greenfield, IN 46140 2007-04-23
Find all providers in zip 46140


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Zip Code 46140

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Dataset Information

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.