Individual provider Active NPI

Stephen Tyler Abbott, D.O.

  • Internal Medicine Physician
  • Sanford, NC
National Provider Identifier
1013216282
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-01108 Issued in NC
Practice address
1135 Carthage St
Sanford, NC 27330-4162
Phone
(919) 774-2350
Fax
(919) 774-2132
NPI assigned
Mar 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2016-01108 NC
Hospitalist Physician 208M00000X 2016-01108 NC
Internal Medicine Physician 207R00000X 2016-01108 NC Primary

Addresses

Primary practice location

1135 Carthage St
Sanford, NC 27330-4162

Mailing address

260 Leigh Farm Rd Apt 401
Durham, NC 27707-8127
Phone (401) 480-4859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817001753 NC Practitioner - Internal Medicine 2961620307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimed HospitalistsGroup PAC ID 8022204171, 47 clinicians

Practice addresses (Care Compare)

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

Hospital & facility affiliations

  • Hospice of Iredell County, Inc Hospice, Statesville, NC, CCN 341517
  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2016-01108NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimed Hospitalists Internal Medicine CurrentSince Aug 19, 2022 Accepting new patients
Optimed Hospitalists Hospitalist Current Accepting new patients

Locations

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1013216282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 LEIGH FARM RD APT 401",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277078127",
            "telephone_number": "401-480-4859",
            "fax_number": "919-774-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304162",
            "telephone_number": "919-774-2350",
            "fax_number": "919-774-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "STEPHEN",
        "middle_name": "TYLER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-27",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2016-01108",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2016-01108",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-01108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.