Individual provider Active NPI

Stephen Justice, MD

  • Family Medicine Physician
  • Sidney, OH
National Provider Identifier
1023014966
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5074 Issued in OH
Practice address
1205 Fairington Dr
Sidney, OH 45365-8144
Phone
(937) 492-8431
Fax
(937) 498-5126
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5074 OH Primary

Addresses

Primary practice location

1205 Fairington Dr
Sidney, OH 45365-8144

Mailing address

1205 Fairington Dr
Sidney, OH 45365-8144
Phone (937) 492-8431

Other identifiers 1

IdentifierTypeStateIssuer
2178996MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephen.justice@wilsonhospital.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100722000331 OH Practitioner - Family Practice 5193851624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilson Care, LLCGroup PAC ID 4385549666, 58 clinicians

Practice addresses (Care Compare)

1205 Fairington Dr
Sidney, OH 45365-8144
Phone 93749284310000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
81.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5074OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Care, LLC Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Wilson Urgent Care CurrentSince Jul 1, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

104 Diamond Dr
Anna, OH 45302
Phone (937) 394-2900

111 E Lynn St
Botkins, OH 45306
Phone (937) 693-1541

11531 State Route 66
Minster, OH 45865
Phone (937) 295-2949

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

915 Michigan St
Ste 100
Sidney, OH 45365
Phone (937) 419-8049

1079 Fairington Dr
Sidney, OH 45365
Phone (937) 419-8015

915 Michigan St
Ste 204
Sidney, OH 45365
Phone (419) 996-5224

750 S 4th Ave
Sidney, OH 45365
Phone (937) 419-8020

1205 Fairington Dr
Sidney, OH 45365
Phone (937) 492-8431

661 N Vandemark Rd
Sidney, OH 45365
Phone (937) 419-5010

Interoperability endpoints

  • Direct secure messaging: sjustice1537808@direct.osumc.edu
  • FHIR API: https://api.platform.athenahealth.com/107/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 5

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1023014966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658144",
            "telephone_number": "937-492-8431",
            "fax_number": "937-498-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658144",
            "telephone_number": "937-492-8431",
            "fax_number": "937-498-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "5074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2178996",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.justice@wilsonhospital.medicity.net",
            "affiliation": "N",
            "address_1": "1205 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.