Active NPI
Stephen T Medford
- Attendant Care Provider
- O'Fallon, IL
National Provider Identifier
1104437797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 1017 Hartman LN
O Fallon, IL 62269-7207 - Phone
- (618) 531-3007
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
1017 Hartman LN
O Fallon, IL 62269-7207
Mailing address
1017 Hartman LN
O Fallon, IL 62269-7207
Phone (618) 531-3007
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597536000000",
"number": "1104437797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 HARTMAN LN",
"city": "O FALLON",
"state": "IL",
"postal_code": "622697207",
"telephone_number": "618-531-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 HARTMAN LN",
"city": "O FALLON",
"state": "IL",
"postal_code": "622697207",
"telephone_number": "618-531-3007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDFORD",
"first_name": "STEPHEN",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-16",
"last_updated": "2020-08-16",
"certification_date": "2020-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O'Fallon, IL
- Michelle Denise McQuillan, DNP, FNP-BC
- MDM Healthcare Inc (ofallon pharmacy medicine shoppe)
- Bailey Paige Meadows, BEHAVIOR TECHNICIAN
- Zachary Medema, M.S.
- Medexpress Urgent Care Illinois, PC (MedExpress Urgent Care - O'Fallon, W Highway 50)
- Nitika Dinesh Mehta, D.D.S.
- Gerusa Mello-Anderson, D.D.S.
- Rai'Annah Lori Mendez
- Jeannette Mendoza-Martinez
- Myah Rae Mense
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.