Active NPI
Janice Stidham
- Speech-Language Pathologist
- Russellville, AL
National Provider Identifier
1013399260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1096
- Practice address
- 701 Monroe St NW
Russellville, AL 35653-1358 - Phone
- (888) 873-4221
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1096 | AL | Primary |
Addresses
Primary practice location
701 Monroe St NW
Russellville, AL 35653-1358
Mailing address
701 Monroe St NW
Russellville, AL 35653-1358
Phone (888) 873-4221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1096 | AL | MD | Metabolic Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1013399260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 MONROE ST NW",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "356531358",
"telephone_number": "888-873-4221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 MONROE ST NW",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "356531358",
"telephone_number": "888-873-4221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIDHAM",
"first_name": "JANICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "1096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AL
- State of Alabama Department of Public Health
- Sterling Emergency Services of Alabama Inc
- Steven D. Hammack D.M.D.
- Wayne B Stevens, OD
- Kaitlyn Stewart
- Lauren N Stirling, O.D.
- Nina J Stowe, CRNP
- Tabatha Michelle Sutherland Marbutt, MSN, APRN, FNP-C
- Taylor Grace Tackett, DOCTOR OF OPTOMETRY
- The Drug Shop LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.