DR. KENNA J STEPHENSON (MD) – Family Medicine Physician, NPI 1962697755

DR. KENNA J STEPHENSON (MD) is a healthcare provider. based in Dallas, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. H8435 (TX). The NPI Number for DR. KENNA J STEPHENSON (MD) is 1962697755

Main info

Female
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNA J STEPHENSON (MD)
NPI
1962697755
Phone
(903) 877-2827
Address
PO BOX 847824
Enumeration Date
13 September 2007
Last Update Date
13 October 2025

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
9289107010
Graduation Year
1989 (37 years ago)
PAC ID
2860570033
Group Practice PAC ID
0749506269
Professional Enrollment ID
I20211013001513
Address ID
AZ863141222PR3221XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:18State licenses:2Digital endpointsOther names

8,706 FAMILY PRACTICE in TX

Provider Addresses for DR. KENNA J STEPHENSON (MD)

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 752847824

    Phone: (903) 877-2827

    Fax: (903) 877-5661

    Type: Mailing

  • 11937 HWY 271

    TYLER, TX 757083154

    Phone: (903) 877-2827

    Fax: (903) 877-5661

    Type: Location

  • 2945 W Ina Rd Ste 215&221

    Tucson, AZ 857412350

    Phone: (520) 616-1531

    Fax: (520) 616-1536

    Type: Location

  • 3212 N Windsong Dr Ste 200

    Prescott Valley, AZ 863142255

    Phone: (928) 583-1000

    Fax: (866) 751-4157

    Type: Location

  • 1090 COMMERCE DR

    PRESCOTT, AZ 863053700

    Phone: (928) 583-1000

    Fax: (866) 323-8458

    Type: Location

  • PO BOX 188

    MARANA, AZ 856530188

    Phone: (520) 616-1531

    Fax: (520) 616-1536

    Type: Mailing

  • 1998 PRESCOTT LAKES PKWY

    PRESCOTT, AZ 863017825

    Phone: (928) 582-1130

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $298.

Total Amount is formed as General ($298) + Research ($0) + Ownership ($0) = $298.

Last reported payment date: 2024-10-15 • Largest payer in this snapshot: BIOTRONIK INC. ($153).

Total Amount

$298

General + Research + Ownership

Payments

4

Total payment records

General Amount

$298

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-10-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180907000981IFamily PracticeGUTBD
I20211013001513IFamily PracticeAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99204New patient office or other outpatient visit, 45-59 minutes1919$0
99213Established patient office or other outpatient visit, 20-29 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 75284)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749506269View full group profile
NameSpecialtyState
Internal MedicineAZ
Physician AssistantAZ
General PracticeAZ
Physical Therapist In Private PracticeWI
Orthopedic SurgeryAZ
-AZ
Physical Therapist In Private PracticeCO
Nurse PractitionerAZ
-AZ

Reviews

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Frequently asked questions

Does DR. KENNA J STEPHENSON (MD) have a public NPI I can cite?
Public records show DR. KENNA J STEPHENSON (MD) under NPI 1962697755.
Is DR. KENNA J STEPHENSON (MD) currently accepting referrals based on NPI status?
Registry metadata lists DR. KENNA J STEPHENSON (MD) as active.
What services align with DR. KENNA J STEPHENSON (MD)'s listing?
DR. KENNA J STEPHENSON (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. KENNA J STEPHENSON (MD)?
DR. KENNA J STEPHENSON (MD) is associated with Dallas, Texas in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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