NPIMap

Organization Active NPI

Stibal Surgical Center

  • Surgery Physician
  • Albemarle, NC
National Provider Identifier
1104005602
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
32583 Issued in NC
Legal business name
STIBAL SURGICAL CENTER
Practice address
303C Yadkin St
Albemarle, NC 28001-3441
Phone
(704) 983-3500
Fax
(704) 983-3763
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Dr. Darlene M Stibal, MDNPI 1639114887
Title
Owner/Physician
Phone
(704) 983-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 32583 NC Primary

Addresses

Primary practice location

303C Yadkin St
Albemarle, NC 28001-3441

Mailing address

303C Yadkin St
Albemarle, NC 28001-3441
Phone (704) 983-3500

Other identifiers 2

IdentifierTypeStateIssuer
80035OtherNCBCBSNC
8980035MedicaidNC

National Provider Directory

National Provider Directory

Locations

303 Yadkin St
Ste C
Albemarle, NC 28001
Phone (704) 983-3500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1104005602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303C YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013441",
            "telephone_number": "704-983-3500",
            "fax_number": "704-983-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303C YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013441",
            "telephone_number": "704-983-3500",
            "fax_number": "704-983-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STIBAL SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "STIBAL",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "704-983-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "32583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "80035",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980035",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.