NPIMap

Individual provider Active NPI

Stephen Michael Entrekin, P.A.

  • Surgical Physician Assistant
  • Gadsden, AL
National Provider Identifier
1083818751
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 107 Issued in AL
Practice address
815 Riverbend Dr
Gadsden, AL 35901-2556
Phone
(256) 456-0228
Fax
(256) 456-0231
NPI assigned
Jun 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 107 AL Primary

Addresses

Primary practice location

815 Riverbend Dr
Gadsden, AL 35901-2556

Mailing address

815 Riverbend Dr
Gadsden, AL 35901-2556
Phone (256) 456-0228

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 107ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Medical Center Clinic PA Past Accepting new patients
Cardiothoracic & Vascular Surgery, PA Past Accepting new patients
Allergy Associates, Inc Past Accepting new patients
Phoenix Neurological Institute, Inc PastSince Aug 1, 2024 Accepting new patients
Cardiovascular Surgical Associates Past Accepting new patients
Cookeville Regional Medical Group, Inc Surgical PastSince Apr 8, 2019 Accepting new patients
Abdul Memon, MD, PLLC PastSince Apr 15, 2024 Accepting new patients
Lamberth & Ronson, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083818751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 RIVERBEND DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359012556",
            "telephone_number": "256-456-0228",
            "fax_number": "256-456-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 RIVERBEND DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359012556",
            "telephone_number": "256-456-0228",
            "fax_number": "256-456-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTREKIN",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA 107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.