Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Caroline Derrick Stephens, PA

Individual provider Physician Assistant · NPI 1124637905

Caroline Derrick Stephens, PA is a Physician Assistant in Johnson City, Tennessee. Qualified in 2020, 6 years ago. Accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2340 Knob Creek Rd Ste 704
Johnson City, TN 37604-2977
Phone: (423) 929-9101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1124637905
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 28, 2020
Last updated in NPPESJanuary 22, 2026
Certification dateJanuary 22, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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