NPIMap

Individual provider Active NPI

Stephen Gordon Remine, M.D.

  • Surgery Physician
  • Roanoke, VA
National Provider Identifier
1215939426
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301076893 Issued in MI
Practice address
3 Riverside Circle
Dept of Surgery
Roanoke, VA 24016
Phone
(540) 224-5170
Fax
(540) 983-8212
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301076893 MI Primary

Addresses

Primary practice location

3 Riverside Circle
Dept of Surgery
Roanoke, VA 24016

Mailing address

3 Riverside Circle
Roanoke, VA 24016
Phone (540) 224-5170

Other identifiers 4

IdentifierTypeStateIssuer
424506610MedicaidMI
4301076893OtherMICONTROLLED SUBSTANCE
010174767MedicaidVA
010174759MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827001638 SC Practitioner - General SurgeryPractitioner - Family PracticePractitioner - Surgical Oncology 0547215196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Family Practice
Education
University of Minnesota Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care and Family Medicine Conway LLCGroup PAC ID 8325474497, 3 clinicians

Practice addresses (Care Compare)

235 Singleton Ridge Rd
Suite 103
Conway, SC 29526-9136
Phone (843) 347-2121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076893MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Carenow Urgent Care, LLC CurrentSince Sep 1, 2021 Accepting new patients
Urgent Care & Family Medicine Conway, LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

235 Singleton Ridge Rd
Ste 103
Conway, SC 29526
Phone (843) 347-2121

9820 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 449-2273

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1215939426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIRCLE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24016",
            "telephone_number": "540-224-5170",
            "fax_number": "540-983-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIRCLE",
            "address_2": "DEPT OF SURGERY",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24016",
            "telephone_number": "540-224-5170",
            "fax_number": "540-983-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMINE",
        "first_name": "STEPHEN",
        "middle_name": "GORDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301076893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424506610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "4301076893",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010174767",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010174759",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.