Individual provider Active NPI

Stephen Daniel Avila, MD

  • Neurology Physician
  • West Hollywood, CA
National Provider Identifier
1093394058
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
75579 Issued in TN
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-3277
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 109305 GA
Neurology Physician 2084N0400X MD70032263 WA
Neurology Physician 2084N0400X 0101287357 VA
Neurology Physician 2084N0400X 28754 NV
Neurology Physician 2084N0400X 2025-03812 NC
Neurology Physician 2084N0400X MD227293 OR
Student in an Organized Health Care Education/Training Program 390200000X CA
Neurology Physician 2084N0400X 036177384 IL
Neurology Physician 2084N0400X 75579 TN Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Other practice location 1

1519 Main St
Sneedville, TN 37869-3657
Phone (423) 733-5070

Other practice location 2

1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000

Other practice location 3

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300

Other practice location 4

1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1103

Other practice location 5

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-3733

Other practice location 6

245 Medical Park Dr
Marion, VA 24354-1100
Phone (276) 378-1000

Other practice location 7

312 Hospital Dr
Clintwood, VA 24228-6786
Phone (276) 926-0300

Other practice location 8

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 523-3111

Other practice location 9

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Other practice location 10

127 Health Care Dr
Pennington Gap, VA 24277-2853
Phone (276) 546-5212

Other practice location 11

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 225-6111

Other practice location 12

2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000

Other practice location 13

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121

Other practice location 14

851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000

Other practice location 15

100 15th St NW
Norton, VA 24273-1616
Phone (276) 439-1000

Other practice location 16

58 Carroll St
Lebanon, VA 24266-4510
Phone (276) 883-8000

Other practice location 17

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Other practice location 18

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other practice location 19

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, IL, TN, VA, CA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20251030003875 WA Practitioner - Neurology 8820587652 Reassigns benefits to 1 organization
I20251030005150 OR Practitioner - Neurology 8820587652 Reassigns benefits to 1 organization
I20251224001720 IL Practitioner - Neurology 8820587652 Reassigns benefits to 1 organization
I20260115002733 TN Practitioner - Neurology 8820587652 Reassigns benefits to 1 organization
I20260203000400 VA Practitioner - Neurology 8820587652 Reassigns benefits to 1 organization
I20260317003111 CA Practitioner - Neurology 8820587652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, shared by 2 NPIs, 432 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430

1 Medical Park Blvd
Suite 250W
Bristol, TN 37620-7431
Phone (423) 844-6620

100 15TH St NW
Norton, VA 24273-1616
Phone (423) 630-7001

111 W Stone Dr
Kingsport, TN 37660-6027

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 630-7001

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 630-7001

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-8386

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036177384ILMDNeurology Physician
MD227293ORMDNeurology Physician
75579TNMDNeurology Physician
0101287357VAMDNeurology Physician
MD70032263WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Oct 16, 2025 Accepting new patients
Riverside Health System CurrentSince Dec 15, 2025 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Feb 1, 2026 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Feb 1, 2026 Accepting new patients
Centra Medical Group, LLC CurrentSince Jan 18, 2026 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 16, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 16, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Oct 16, 2025 Accepting new patients
Singing River Health System Past Accepting new patients
Riverside Health System Past Accepting new patients

Locations (25 of 26)

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

24800 SE Stark St
Fl 3
Gresham, OR 97030
Phone (503) 674-1122

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2000 Brookside Dr
Kingsport, TN 37660
Phone (423) 857-7144

1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

1519 Main St
Sneedville, TN 37869
Phone (423) 733-5000

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

312 Hospital Dr
Clintwood, VA 24228
Phone (276) 439-1450

245 Medical Park Dr
Marion, VA 24354
Phone (276) 378-1000

100 15th St NW
Norton, VA 24273
Phone (276) 439-1000

127 Health Care Dr
Pennington Gap, VA 24277
Phone (276) 299-5000

Networks

  • LA PPO C-SNP

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1093394058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 Main St",
            "address_purpose": "LOCATION",
            "city": "Sneedville",
            "state": "TN",
            "postal_code": "378693657",
            "country_code": "US",
            "telephone_number": "423-733-5070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454279",
            "country_code": "US",
            "telephone_number": "423-787-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 W Elk Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432874",
            "country_code": "US",
            "telephone_number": "423-542-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Shady St",
            "address_purpose": "LOCATION",
            "city": "Mountain City",
            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-1103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-3733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243541100",
            "country_code": "US",
            "telephone_number": "276-378-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "312 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Clintwood",
            "state": "VA",
            "postal_code": "242286786",
            "country_code": "US",
            "telephone_number": "276-926-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 Holton Ave E",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193350",
            "country_code": "US",
            "telephone_number": "276-523-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042277",
            "country_code": "US",
            "telephone_number": "423-302-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 Health Care Dr",
            "address_purpose": "LOCATION",
            "city": "Pennington Gap",
            "state": "VA",
            "postal_code": "242772853",
            "country_code": "US",
            "telephone_number": "276-546-5212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-225-6111",
            "fax_number": "423-630-7019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 Locust St",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "TN",
            "postal_code": "378572407",
            "country_code": "US",
            "telephone_number": "423-921-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 15th St NW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731616",
            "country_code": "US",
            "telephone_number": "276-439-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Carroll St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242664510",
            "country_code": "US",
            "telephone_number": "276-883-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Tarboro",
            "state": "NC",
            "postal_code": "278862011",
            "country_code": "US",
            "telephone_number": "252-641-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA",
        "first_name": "STEPHEN",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "109305",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD70032263",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101287357",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "28754",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2025-03812",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD227293",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036177384",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "75579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.