Individual provider Active NPI

Robert Logan Staples, MD

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1225658248
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.45383 Issued in AL
Practice address
247 Chateau Dr SW
Huntsville, AL 35801-6401
Phone
(256) 882-1510
Fax
(256) 217-5838
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AL
Family Medicine Physician 207Q00000X MD.45383 AL Primary

Addresses

Primary practice location

247 Chateau Dr SW
Huntsville, AL 35801-6401

Mailing address

247 Chateau Dr SW
Huntsville, AL 35801-6401
Phone (256) 882-1510

Other practice location 1

301 Governors Dr SW
Huntsville, AL 35801-5123
Phone (256) 551-4631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230821000258 AL Practitioner - Family Practice 2163844127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innova Primary Care, PCGroup PAC ID 4688845571, 14 clinicians

Practice addresses (Care Compare)

247 Chateau Dr SW
Huntsville, AL 35801-6401
Phone (256) 882-1510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innova Primary Care, PC Family Medicine CurrentSince Jul 8, 2023 Accepting new patients

Locations

247 Chateau Dr SW
Huntsville, AL 35801
Phone (256) 533-9393

145 Research Blvd
Ste 100
Madison, AL 35758
Phone (256) 882-1510

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFECDA

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1225658248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CHATEAU DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016401",
            "telephone_number": "256-882-1510",
            "fax_number": "256-217-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 CHATEAU DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016401",
            "telephone_number": "256-882-1510",
            "fax_number": "256-217-5838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Governors Dr SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015123",
            "country_code": "US",
            "telephone_number": "256-551-4631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "ROBERT",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.45383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.