Individual provider Active NPI

Stephen M Hughes, MD

  • Dermatopathology (Pathology) Physician
  • Fayetteville, AR
National Provider Identifier
1053536060
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
E-4597 Issued in AR
Practice address
4375 N. Vantage Dr.
Suite 305
Fayetteville, AR 72703-4984
Phone
(479) 443-5100
Fax
(479) 443-5117
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Arkansas College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozark Dermatology Clinic 15 clinicians

Practice addresses (Care Compare)

4375 N Vantage Dr
Suite 305
Fayetteville, AR 72703-4984
Phone (479) 335-1831

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20130827000672 AR Practitioner - Pathology 9436392289 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4597ARMDInternal Medicine Physician
TL31228SCMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Dermatology Clinic CurrentSince Sep 1, 2013 Accepting new patients
Ameripath SC Inc PastSince Sep 1, 2013 Accepting new patients

Locations

4375 N Vantage Dr
Ste 305
Fayetteville, AR 72703
Phone (479) 443-5100

117 S Dixieland St
Ste C
Lowell, AR 72745
Phone (479) 347-2700

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E4597 AR
Dermatopathology (Pathology) Physician 207ZD0900X TL31228 SC
Dermatopathology (Pathology) Physician 207ZD0900X E-4597 AR Primary

Addresses

NPPES NPI Registry

Primary practice location

4375 N. Vantage Dr.
Suite 305
Fayetteville, AR 72703-4984

Mailing address

4375 N. Vantage Dr.
Suite 305
Fayetteville, AR 72703-4984
Phone (479) 443-5100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2013.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1053536060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N. VANTAGE DR.",
            "address_2": "SUITE 305",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034984",
            "telephone_number": "479-443-5100",
            "fax_number": "479-443-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 N. VANTAGE DR.",
            "address_2": "SUITE 305",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034984",
            "telephone_number": "479-443-5100",
            "fax_number": "479-443-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E4597",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "SC",
            "license": "TL31228",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AR",
            "license": "E-4597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.